On the Poetics and Politics of Health

By Rita Charon and Jonathan Metzl

Combining first-person narration, scholarly reflections, and advocacy, this volume features conversations with physician-scholars Rita Charon and Jonathan M. Metzl and provides a holistic view of the human interactions and structural forces that define healthcare today. The contributors afford us opportunities to reconsider health through a poetic and political lense and help us envision a more socially informed and just practice of medicine.

• Language: English
• Publisher: BookBaby
• Release date: Sep 17, 2021
• ISBN: 9781936994106

Book preview

Aaron Levy and Josh Franklin

Introduction

Throughout the COVID-19 pandemic, public health measures such as the use of masks, social distancing, lockdowns, school closures, and even vaccination have been objects of partisan debate, at times leading to heated protest and violent confrontation. In response, voices from across the political spectrum have frequently insisted that science and public health ought to be beyond politics and have accused the other side of manipulating science to support their own political and economic interests.

One unintended consequence of these debates is that they have made legible the contested status of science today, affording us an opportunity to fundamentally reevaluate the relationship between public health, public policy, and science itself. What should be the place of science in political life? What role should science play in shaping our collective response to global crisis?

It is widely assumed that science is natural, universal, and benevolent; politics, on the other hand, is human, provincial, and malign. Yet this rendering of science and politics as separate spheres obscures the fact that science as a way of knowing is itself a human process, and as such, it too is flawed and inherently political. What does it mean, then, to say that there is a politics of health? It is to state something that is perhaps obvious to many in the humanities and social sciences, yet from a scientific perspective often goes unstated: our health and well-being are impacted by social and environmental factors and disparities.

A lack of access to healthy food, clean air and water, and economic and educational opportunity; the trauma of recurrent exposure to racism and state violence; long-standing inequities in healthcare delivery and access; and heightened vulner-ability to SARS CoV-2 and other pathogens are just a few examples of how one’s environment — and the social, political, and institutional forces that condition it — profoundly shapes one’s health.

The understanding that inequities such as these are not coincidental but central to the operation of power in contemporary society is something that historians, philosophers, and social scientists have long observed. This is evident in the work of Michel Foucault, who famously called the productive and life-sustaining dimensions of government biopolitics, as well as the work of Gilles Deleuze, Ann Stoler, Achille Mbembe and others who have in different ways highlighted the foundational colonial violence at the heart of the modern nation and the persistence of state violence as central to governmentality. These authors are only a few among the many in disciplines from history to sociology and philosophy who have explored the multidimensional relationship between human life and politics. Drawing from these scholars and others, we employ the term health ecologies as a critical framework for those seeking to not only make visible the impact of social systems on the health of individuals and communities but actively challenge them.

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If a central preoccupation of this publication is that health is always and necessarily political, another is that a poetics of health is fundamental to any effort at reimagining the politics of care. By the poetics of health, we refer to the essential forms of humanistic thought that may be obscured by the technical language of medicine, and the primacy of listening in any practice of caregiving.

Indeed, Dr. Rita Charon proposes in this volume that We have to listen for the unheard. We listen for the unsaid. and Dr. Jonathan M. Metzl exhorts, listening itself is a political act. Both speak to the power and poetics of listening as a form of diagnosis and care, the way in which care best occurs at the intersection of the everyday practice of medicine, the complex human encounters that give meaning to health, and the enunciation of new political collectives.

Through their responsiveness to the transformations occurring around them, they also remind us of the importance of reflecting on the times in which we live and how this demands both a politics and a poetics. As we struggle today to find a language to talk about the pandemic, it is worth noting that Dr. Charon’s and Dr. Metzl’s contributions to this volume predate COVID-19. Nevertheless, they illuminate the continuities between this crisis and all that precedes it. We hope that this publication will help us all navigate a pandemic which has only brought the urgency of these matters to the forefront all the more.

If this publication foregrounds ideas around healing and care, it emerges at a historical moment in the direct aftermath of the Trump administration, which has revealed the limitations of democratic governance to these