An open letter to social media philanthropists

To all the friends who are seeking my support for Dry July, ice challenges, Movember etc., I salute you. Far too few people are prepared to give to others. But I won’t be donating to the organisations you’re raising money for. Before you respond with “Well, fuck you too”, which is what I’d do in the same situation, and before I discuss why, here is a list of what I’d like you to ask me to support instead, in order of what I see as their capacity for creating meaningful change:

1) A group that you belong to and contribute your time to that is trying to change why injustices (including health injustices) occur;

2) A fund to support you if you need help or specific people you support with your time who need help;

3) An organisation or group that works to provide critical information on the actions of governmental and corporate organisations that direct the politics of social issues (not “raising awareness”).

Last night I was at my first local community meeting in years — we’ve been to a lot of protests, not the same — to save nurse practitioner services in our area and I was reminded that the various health social movements we are encouraged to support on social media are either indifferent to or actively opposed to the three activities above. I’ll try and outline these from more concrete issues to the philosophical underpinnings.

1) The programmes that are supported, in the case of almost all major cancer organisations, are part of the “health industrial complex” that Clarke call biomedicalisation: the shift of care resources to capital-intensive, technoscientific, cure-products. The people working for the companies and universities involved in the research funded through the various anti-cancer councils and groups make a lot of money for their good works. But go to a campaign website and try and find out how this affects those who most need health intervention, preferably from those who express that need (we’re in a “participatory society”, right?). Good luck. Like the development industry it underwrites high salaries with the pain of others who have limited involvement in their institution’s governance. All the “evaluation” studies compound the problem. No matter how “accountable, transparent, and efficient” these organisations are, their net effect is the concentration of wealth, which is the major determinant of health.

2) The non-scientific care organisations supported by these campaigns are often hospital facilities that are the remnants of the public health system. The privatisation of the health system is in the interests of the wealthy, and we cannot expect doctors to be advocates for public health: the medical profession opposed publicly financed, single-payer universal health care coverage almost everywhere in the former British empire in the 20th century – that’s why groups like the Doctors Reform Society were established by renegade professionals to fight their conservative colleagues for public health. It’s not that cash-strapped formerly state-run institutions shouldn’t be supported but, as with the education system, there is certainly no guarantee that these are being governed in the public interest. Whether or not they have an explicit political agenda, health-cooperatives that are governed in the interests of their members are making a return and perhaps this model suits the “participatory times” we are in. The union hospital that cared for my great-grandfather (a migrant miner) at his death is more the kind of care organisation for the ill that seems valuable to support.

3) The campaigns de-politicise health. The relationship to the organisations themselves is purely through financial means that remove us from the human relationships that constitute them, even while the issues that motivate us to contribute (life and death of family and friends) are starkly human. Actual healthcare, as anyone who has engaged the systems knows, is a deeply political field structured by values about the worthiness of some forms of life over others in a resource-constrained world. The financialisation of our donor relationship to health has two negative effects on public life and democratic ideals:

a) The organisations working on health have incentives to avoid publicly speaking out on health system issues that would jeopardise support from the wealthy. This creates a domesticated discourse of health that cannot speak freely about what is actually causing health issues. Thus the dominance of randomised control trials of individualist interventions (pharmaceutical / behavioural), while social health is directed to “health promotion”, which as I have learned from Ruth, is a discourse of “responsibilisation” and the Protestant ideology that you will get what you individually work for.

b) Though our philanthropic acts we shield ourselves from involvement in the messy politics of care. We financialise our personal gesture of renunciation, pain or (in the case of Dry July) even our own health to turn it into money, the unproblematic good. The money, given over, cannot by definition be bad, as we all need it: in market discourse, at worst, it is wasted. But we are not on the hook for how the money – our labour – is spent except that we succeed or fail at our own goal. (The ice challenge, a derivative of the salt-and-ice challenge, seems to its credit to be less corporate-sponsored/formatted, but it still won’t surprise me if an ad agency has been behind its charitification somewhere)

While it may appear esoteric, it’s the guarantee of having done good is at the heart of my resistance to viral health social movements. Health is defined in our world as the absence of illness, to be guarded against and warded off. Illness comes from outside, in Calvinist terms as a punishment from God, that we can resist through control of ourselves and obedience to the Good against the sin of the body and the other. The dependence illness brings attacks precisely this resistance, testing the limits of our own capacity and resources as a caring self, calling into question our ability to “do right”. In the presence of a body that is no longer in control, faced with the inevitability of our own decomposition, caring for a specific other confronts us with how thin our aspirations and actions for social health are compared to the thick institutional politics of intimate care. It is often less “doing good” than than being undone by the absence of good.

All carers I have known have been the most articulate observers of the limits of doing good, and on how much easier lives would be if those at the care interface had even a minor share of the resources that go into the philanthropic health industrial complex. As I spend more time with the literature on nursing, I become clearer how completely distinct that historical ethic is from the world of technoscientific biomedicine (though this too is changing with nursing professionalisation). Activists have taught me that escaping the genre of individual acts and gestures (no matter how socially valorised or viral or financially successful they are) is critical in escaping the industrial modes of relation that hide our dependence on others for well-being. Sylvia Federici advocates the need for not a socialised form of production, but a collective form of reproduction, that organises the social through our dependence on each other from birth through death. I don’t know how we learn to direct our personal impulse of “doing good for the world” toward that inevitably political work of collectively working for all lives to be healthy, but I do know that charity-sponsored donation campaigns have no interest in helping us get us there.

Trigger warnings and institutional ethics

A number of smart people have been sharing this Inside Higher Ed post by faculty members on why they will not use Trigger Warnings, and it is one of the best I’ve seen so far, I think because it is a collective text and therefore more careful than most anti-trigger warning arguments that ultimately resort to dismissal (I love Kang’s stuff so was disappointed in that New Yorker piece).  I have not been keeping up with the ever-increasing pile of op-ed, much of which wins transartorialism’s Trigger Warning Op-Ed Bingo. There is something about the op-ed form that is itself the biggest problem in this discussion I suspect, and I have learned the most in debate in the Entropy series, which performs the decomposition of held opinion that I think critical scholars resisting TWs are trying to hold onto.

But even the most careful version of “Trigger Warnings Are Flawed” seems weak against the fundamental forces that have brought TWs to the prominence they have. In no particular order and far from comprehensive, I would list:

Firstly, a range of collective languages for trauma, first institutionalised in the United States but today globalised via the internet, that the historical version of the modern university has been indifferent to and has no mechanism to engage;

secondly, a massive growth in non-male participation in the university institution which largely existed to reproduce the patriarchal order, and whose genres of work largely reflect that order;

thirdly, the marketisation of the university that places the individual consumer at the centre of the teaching experience, who deserves value and service from an institution that has historically aimed to exclude without responsibility to anyone other than itself

fourthly (related) a “culture of the self” trackable through the development of social media worlds where one’s political goals are engaged through expressive participatory individuality. One has a “profile” as a hashtag or tumblr activist to tend with/against others as an authorial persona, and the form of that authorship has a technical structure that is more responsive to a social world than any previous form of writing, but with mechanisms of response that are individualised (as I explored in relation to Facebook here). In this mode of activism, one’s own body can collectively represent friends and followers – one’s own freedom can stand in for others. In her superb discussion with Dave Chappelle, Dr Maya Angelou speaks of the “icon” whose key characteristic is expressive courage. It seems to me that this type of identity-driven activism is the modality behind TW and related moves to bend the institutional world toward an ethics of individual respect. It says, “I am here, and I am not going to let you not see me.” This version of individual political action is quite different than the “opting out” the baby boomer generation understood as constitutive of individuality – but those individuals of the boomer generation and gen-X largely didn’t critique their own class position that made their “negativity” legible in the political calculus.

The above suggests that the trigger warning is an epochal, complex, intractable problematic – the most valuable move of the Entropy series was to discuss the generational aspects head on. But I think the biggest issue is what is at stake in the institutionalisation of these gestures. The “trigger warning” as expression of the ethical interpersonal relation between writer/reader or teacher/student has presented itself in a format that is beginning to be appropriated by a university bureaucracy that sees its potential for corporate risk management. That appropriation (not the appearance of or not of TWs) is what I think leads to the negative effects the “Trigger Warnings Are Flawed” authors elaborate (policing, deflecting of what should be institutional support to the classroom), no matter how many individuals are properly prevented from needless trauma by its institutionalisation. I’ve seen as few arguments for trigger warning policies that are grounded in a realistic analysis of institutional governmentality as I’ve seen arguments against them that are genuinely engaged in the political worlds from which TWs have emerged. As I wrote above, I don’t have a synoptic overview that could diagnose what the state of the discourse is. But I do know from experience that the policing of content works differently in an big-city research university than it does in a highly-religious teaching-oriented institution, and that the fusing of the ethical with the legal is always dangerous, however inevitable.

I don’t know what a trigger is, and I don’t like warnings generally. In my own teaching I would usually, but not consistently, aim to give content notifications for students at the start of my lectures on Gómez-Peña, for example, if there were going to be visuals that were not what students are likely to have encountered in their learning previously. I’ve no desire to put students through something they don’t want to experience. But unlike many academics commenting on the linked article, I don’t think my own individual reflex is sufficient to determine what those guides should be. In one of my first conference presentations during my brief period of work on colonial knowledge in 2004, I completely inappropriately showed images of Als and Allens’ collections of postcards of historical US lynchings. It was gratuitous and unnecessary, probably harmful for some. At the time I had no language to understand why, and luckily someone took the time to set me straight afterward, to remind me that I had no right to believe I had access to all of the stakes in what those images could do in that room. It’s one of those scenes of failure that has haunted me since, and made me realise how weak my own self-training in affect management has been. I’m a better teacher because of that failure, and realise more clearly now that I need other people’s eyes on my work, and I’ve tried to stop writing about things that are not mine to know, and to instead work with others on understanding what those historical ruptures are.

In a way, that very experience made me understand why a trigger warning is not a solution in the classroom: it still relies on an individual teacher taking responsibility for themselves, when the issues that require trigger warnings are collective problems, larger than any class. The smallest amount of support for minor experiments in collective teaching would, I think, better address the challenges of making the university a more ethically responsive place. But as anyone who has tried to implement such initiatives knows, the institutional forces that individualise answerability (as an infantilised version of responsibility) among both teachers and students are incredibly difficult to shift. Until we are able to shift them, we will have the debate on trigger warnings and other mechanisms to reconcile the institution to its ethical responsibilities, and we will need it.