Consultations Gratuites
Moutarde Blanche
Physician King (offering)
Free of charge consultations (prescribing)
White Mustard (pointless remedies)
In his own words, “trained as a medieval historian and philosopher” and who taught “about the history of friendship and the history of the art of suffering”, Ivan Illich wrote about The Medicalization of Life in Medical Nemesis: The Expropriation of Health. First published in 1974, the Introduction leads off with, “The medical establishment has become a major threat to health. The disabling impact of professional control over medicine has reached the proportions of an epidemic. Iatrogenesis, the name for this new epidemic, comes from iatros, the Greek word for ‘physician,’ and genesis, meaning ‘origin.’”
The technical and the nontechnical consequences of institutional medicine coalesce and generate a new kind of suffering: anesthetized, impotent, and solitary survival in a world turned into a hospital ward. Medical nemesis is the experience of people who are largely deprived of any autonomous ability to cope with nature, neighbors, and dreams, and who are technically maintained within environmental, social, and symbolic systems. Medical nemesis cannot be measured, but its experience can be shared. The intensity with which it is experienced will depend on the independence, vitality, and relatedness of each individual…. [p. 104]
Medical nemesis is resistant to medical remedies. It can be reversed only through a recovery of the will to self-care among the laity, and through the legal, political, and institutional recognition of the right to care, which imposes limits upon the professional monopoly of physicians.[p. 12]
In Chapter 2, The Medicalization of Life, Illich observes how “The higher the price tag at which well-being is commandeered, the greater will be the political prestige of an expropriation of personal health.”
In the final Chapter, The Recovery of Health, The Right to Health calls for a halt to the expropriation of every person’s coping ability and presents an alternative to the inevitable Medical Nemesis that will set in unless the autonomy of the individual is re-established.
Increasing and irreparable damage accompanies present industrial expansion in all sectors. In medicine this damage appears as iatrogenesis. Iatrogenesis is clinical when pain, sickness, and death result from medical care; it is social when health policies reinforce an industrial organization that generates ill-health; it is cultural and symbolic when medically sponsored behavior and delusions restrict the vital autonomy of people by undermining their competence in growing up, caring for each other, and aging, or when medical intervention cripples personal responses to pain, disability, impairment, anguish, and death.
Most of the remedies now proposed by the social engineers and economists to reduce iatrogenesis include a further increase of medical controls. These so-called remedies generate second-order iatrogenic ills on each of the three critical levels: they render clinical, social, and cultural iatrogenesis self-reinforcing.
The most profound iatrogenic effects of the medical technostructure are a result of those nontechnical functions which support the increasing institutionalization of values. The technical and the nontechnical consequences of institutional medicine coalesce and generate a new kind of suffering: anesthetized, impotent, and solitary survival in a world turned into a hospital ward. Medical nemesis is the experience of people who are largely deprived of any autonomous ability to cope with nature, neighbors, and dreams, and who are technically maintained within environmental, social, and symbolic systems. Medical nemesis cannot be measured, but its experience can be shared. The intensity with which it is experienced will depend on the independence, vitality, and relatedness of each individual.
The perception of nemesis leads to a choice. Either the natural boundaries of human endeavor are estimated, recognized, and translated into politically determined limits, or compulsory survival in a planned and engineered hell is accepted as the alternative to extinction. Until recently the choice between the politics of voluntary poverty and the hell of the systems engineer did not fit into the language of scientists or politicians. Our increasing confrontation with medical nemesis now lends new significance to the alternative: either society must choose the same stringent limits on the kind of goods produced within which all its members may find a guarantee for equal freedom, or society must accept unprecedented hierarchical controls[endnote 3: The Honorable James McRuer, Ontario Royal Commission Inquiry into Civil Rights (Toronto: Queen’s Printer, 1968, 1969, 1971). On self-governing professions and occupations, see chap. 79. The granting of self-government is a delegation of legislative and judicial functions that can be justified only as a safeguard to public interests.] to provide for each member what welfare bureaucracies diagnose as his or her needs. [emphasis added]
The articulation of nemesis leading to a choice of defining natural boundaries to human endeavors echoes Jerry Mander’s expression of taking an entirely different route than leaving all discussion to the experts. As well, the “new kind of suffering” described 45 years ago—anesthetized, impotent, and solitary survival in a world turned into a hospital ward—is frighteningly prescient in terms of people being “largely deprived of any autonomous ability to cope with nature, neighbors, and dreams and who are technically maintained within environmental, social, and symbolic systems.”
Of the three levels of iatrogenesis Illich defines and describes—clinical, social, and cultural— beyond the first two, today’s upside-down world is being forced into an unprecedented cultural and symbolic medical chamber of horrors “when medically sponsored behavior and delusions restrict the vital autonomy of people by undermining their competence in growing up, caring for each other, and aging, or when medical intervention cripples personal responses to pain, disability, impairment, anguish, and death.”
Illich’s framing of nemesis in terms of “our contemporary hygienic hubris” is a life-affirming beacon, illuminating what we are collectively in danger of losing, possibly forever.
The Greeks saw gods in the forces of nature. For them, nemesis represented divine vengeance visited upon mortals who infringe on those prerogatives the gods enviously guard for themselves. Nemesis was the inevitable punishment for attempts to be a hero rather than a human being. Like most abstract Greek nouns, Nemesis took the shape of a divinity. She represented nature’s response to hubris: to the individual’s presumption in seeking to acquire the attributes of a god. Our contemporary hygienic hubris has led to the new syndrome of medical nemesis.[endnote 73: The term was used by Honoré Daumier (1810-79). See reproduction of his drawing “Némésis médicale” in Werner Block, Der Artzt und der Tod in Bilden aus sechs Jahrhunderten (Stuttgart: Enke, 1966).
By using the Greek term I want to emphasize that the corresponding phenomenon does not fit within the explanatory paradigm now offered by bureaucrats, therapists, and ideologues for the snowballing diseconomies and disutilities that, lacking all intuition, they have engineered and that they tend to call the “counterintuitive behavior of large systems.” By invoking myths and ancestral gods I should make it clear that my framework for analysis of the current breakdown of medicine is foreign to the industrially determined logic and ethos. I believe that the reversal of nemesis can come only from within man and not from yet another managed (heteronomous) source depending once again on presumptious [sic] expertise and subsequent mystification.
Medical nemesis is resistant to medical remedies. It can be reversed only through a recovery of the will to self-care among the laity, and through the legal, political, and institutional recognition of the right to care, which imposes limits upon the professional monopoly of physicians. [emphasis added]
The medical nemesis our single, supremely gifted human family is confronted with today threatens further evolution of the creative spark to explore what the nature of being human means, bestowed as birthright to all now alive and all that come after us.
