The medical model says it’s all medical, the social model says it’s all social/political. Well, what a false dichotomy. Medicine – it’s knowledge and practices – are social and the our social experiences are embodied and our bodies are unreliable.
So, I read this quote the other day, and have been trying to find a spare moment and some spare energy to discuss why it strikes me. Yes, medicine is social, yes the social is the embodied, but what? Our bodies are unreliable?
Describing and defining our bodies in those terms is the very essence of pathology. It’s the very complaint against the medical model itself: the medical model pathologizes us. So this quote, this comment, while showing the very real and true interconnections between facets of human life and thought and models, has at its core internalized medical pathology.
The medical model pathologizes us, all of us, sooner or later. The medical model pathologizes all human bodies, sooner or later. This is because the medical model pathologizes all deviations from the norm, the perfect, the ideal. And no human body is “the norm”; no human body is perfect or ideal.
Of course, now is a good time to point out that many human models pathologize humanity. (Distressing, much?) The medical model is hardly alone in this. Religion is high on pathologizing being human in general. I was first consciously, inescapably struck by this fact when reading The Life of the Beloved- a very highly recommended Christian book, written to explain the essence of Christianity to non-Christians. The Life of the Beloved distills Christian faith down to four basic tenants, and one is that we are all broken. That humans by definition are broken, that God has broken us on purpose. That our very essence is to be broken (unless we accept divine intervention to facilitate the necessary repairs) and incomplete (again, only fixed by the divine presence). The idea of humans by their very nature needing to be fixed or repaired goes way back.
Plato really didn’t get the ball rolling in the right direction with his talk about shadows and caves. Ideals are not the essence of reality, so fabulous that our minds cannot fathom them in all their glory. The world that we live in is not a poor approximation, a shadow play, of magical and mystical Ideals that we can never approach in this life. That parable has it all backwards. Reality is what we live in and with every day out there in the world. “Ideals” are our crude attempt at summaries and our inadequate oversimplifications of what we experience in reality.
Seriously, Plato, what were you thinking?
We try to distill the real world down to ideals in order to better process and understand our experiences, and this distillation is highly politicized. Ideals not only do not represent human experience as it is actually lived by anyone, but also do not represent humanity equally across the board. Ideals are distillations based on the politics of power and privilege. Who gets to be the ideal? Who gets to be the standard? Who gets to be the norm? The ones in power. The privileged. The colonizers. The elite. After all, those with the gold make the rules, and the means, and the standards. Ideals are tools of power.
“Normal” is just another kind of ideal. It’s a kind of propagandized perfection, and all perfection is fake. It can never be attained. It isn’t real, people.
Nothing is perfect, nothing is finished, and nothing lasts forever.
Averages are tricksy as well. Averages can rather ruthlessly ignore the amazing differences that being human encompasses, while providing meaningless standards that don’t fit any particular person at all. Most people don’t fit the average, even if they aren’t the outliers of the sample, because of the range of difference involved. Averages don’t correlate to real, specific human experiences. Unless it is an average of people who are amazingly similar. Guess who didn’t get taken into consideration there? People who are different, maybe (because they still exist)? I wonder why that is? When the sample affects or is used to determine someone’s humanity, that is pure politics and power all over again.
How much time and effort do members of society spend trying to “fit in” with what is supposedly normal? Or average? Or default? And while this is true in a general sense for everybody, how much more time and effort do marginalized members of society spend trying to attain that same goal? How much of a person’s self-worth and external validation is based on passing as normal? Or on passing more than “those other people”? Talk about horizontal (and hierarchal) violence.
As long as the idea(l) of normality reins supreme in any human context, people will view not only themselves but also other people as broken and in desperate need of repair. And as long as people are insecure about their own place in the power structures and places of privilege, they will focus on how much more broken other people are and how best to fix those other people. You know, the ones who are so much more broken than we are. I mean, we could use a little fixing up, sure, but those guys, wow, we’d better start helping them out right away! Let’s use all our ingenuity and technology and intelligence to fix those other people, all the while patting ourselves on the back for our generous selfless heroism, and being eternally grateful that at least we’re not as broken as they are. Oh look- it’s one of those incredibly broken people being not quite as broken! How inspiring. It’s almost as if they could one day be normal like us.
Only nobody will ever be normal, because normal doesn’t exist.
That’s actually a very good thing. It means we can stop trying to be what we aren’t, what we can never be, and stop fixating on other people- ie, stop behaving so amazingly pathological- and start growing into who we are. As we are. Because we are already human, already whole, already ready to go.
The field of medicine is social, yes. Throughout the history of the long art, society and culture has surely informed, influenced, and inculcated itself into medical knowledge, practices, and practitioners. And societies and cultures are in turn informed, influenced, and inculcated by the human experience of embodiment, which is humanity’s natural state. Our bodies are our sole means of perception and interaction. (Don’t get me started on Descartes- the mind does not exist without the body, okay.) It is these very bodies which make us human and not something else. It is these very bodies which make us real.
And these human bodies are the most reliable things in the world. You can absolutely rely on them to act like human bodies, all the days of their lives. The problem here is not the bodies, but the pathological expectations we impose on our bodies and on being human. We expect our bodies to be perfect, to be normal, to be ideal. But our bodies are none of those things and never will be. Our bodies are human, in all the mindbogglingly non-identical yet equal ways that being human engenders. All our bodies are truly and fully human from the very start until the very end. And our human bodies keep going, keep growing, keep unfolding and unfurling, keep aging, keep breaking down, keep changing and rearranging, all the days of our lives. And that is a beautiful thing. That is what bodies do.
It is utterly reliable.
It is exactly as it needs to be.
Ring the bells that still can ring, forget your perfect offering,
There’s a crack in everything- that’s how the light gets in.
a coherent heart 