November 26, 2009

Thanksgiving, 2009

The autumn rains have begun

but are over for the moment;

leaves float

on the pools of water on the pavement.

The lonely walker hears

only the swift motor-cars.

--Charles Reznikoff

November 10, 2009

The Disconnect

In a recent New Yorker article on Gaza -- but more on what Israel has done and might do with the people and land it has "secured" -- the author inexplicably stammers over Operation Cast Lead, as if the events that transpired and the variation of methods used were somehow irreconcilable.

Lawrence Wright's essay, "Captives," offers a fragmented portrait of the military project, offering loose juxtaposition rather than connecting transitions to report that: a) the Israeli military worked hard to avoid killing civilians when it telephoned targeted homes ahead of time or sprinkled metal warnings on rooftops before sending down the munitions; b) vandalism of the Palestinian homes that were not rocketed, strafed or bulldozed was not tolerated and IDF soldiers were duly punished for transgressions; c) tactics, like the use of white phosphorous, increased civilian deaths but was possibly done in such a way as to fit within the boundaries of a legally sanctioned act; c) the genocidal act of destroying "cultural institutions" was part of the project; d) soldiers were primed for an assault without limit or regard for the human life they would encounter trapped within the area attacked.

Wright's writing creates the sense that the facts and testimony gathered are somehow at odds and they take on a dream-like uncertainty in his presentation. Perhaps this is a way of saying what the Goldstone Report has said without having to align oneself with that product. Perhaps it is meant to communicate the horrific and irrational plight of the "captives" (of whom the Israeli Gilad Shalit is the most noted and symbolic). But perhaps he and the editors are simply unsure of how to connect a democratic nation defending itself legally and with utmost pride in its purpose, righteousness and humanity to a nation that while claiming "self-defense" made the first principle, as one IDF claims, "no innocents." Every child, if not in the old and tired cliche, a potential terrorist, then in this context, a potential "spotter" or "shield" and therefore available as target. (That only, if one accepts the Amnesty International number, 300 children died, the only conclusion can be that Israel used great restraint in applying its own approach).

That the process of sparing selected lives in selected ways is the the quantifying gesture of just wars, the legalizing rationalizations of democratic institutions are possibly more opaque in their process but no less clear in their function than the Spanish El Requerimiento of the early sixteenth-century.

The words calm the bloodied nerves. Pushed out between the method and madness, as rote responses written down in advance, or as a confused postmortem, they maintain the disconnect.

November 8, 2009

Making an Inhumane Science

In the theater of "health care reform," which late last night took a step toward final legislation, the phrase "best practices" has come to stand out as a defining concept of contemporary politics.

Last year, as a candidate, the President said that if we were to design health care from scratch a single-payer system was the preferred and logical model; it would be the supposed wide-spread public resistance to change that dictated smaller steps and compromised measures. The allure of a bi-partisan symbol was something else altogether. But as the minority party resisted any changes to how health care is distributed and paid for, polls repeatedly indicated support for the very idea Obama was in the process of turning from in the name of political realism: namely a single-payer system. Instead of leading, he chose a passive course of capitulation. His to a path of false realism brings into sharper relief the particularities of his technocratic ideology; one that is less about the efficient functioning of government than an avoidance of analysis, decision, or engagement.

Rather than an agonistic stance that eschews pre-packaged mantras for the sake of dialogue, persuasion and the battles of arguing positions, Obama's pattern is to posit as steadfast limits that are mere fictions, and continually promote his practical positions in terms ambiguous and ill-defined. This could seem like a typical third-way politics of opportunism (with the Keynesian elements of liberalism stripped away in our perpetual emergency to become only rhetorical moralizing), but the "best practices" provision of the health care bill reflects Obama's "philosophy" of governance as much as the drone strikes of Afghanistan and Pakistan: one accepts that there are no choices to be made so as to appear, to or to feel, victorious while simply enduring the time of choice.

Evidence-based practice is rooted in the idea that beliefs can be corrected by evidence and that practices can be authorized by the calculations of observing experts. Authority moves from a kind of faith (posited as almost mythic) in the physician to the aggregate determinations of the data. The assumption, or dream, is that a whole range of treatment modalities may be thus liberated from tradition and opened to new (already proven) methods.

The "best practices" language haunting the current health care legislation represents the economic and political leverage that can emerge from those assumptions. When physician Jerome Groopman describes this to the New York Review of Books, we hear how the benefits of clinical analysis quickly give way to an economic calculus that prescribes away the physician's most micro-level interactions with singular patients; patients whose histories, sensibilities, physical and psychological responses vary widely to treatment options. Where there is, and there can only be, conjecture in the face of the individual, the aphoristic, the bodily clue of symptom, there will be, the legislation promises, something more predictable, managed, enduring. Influenced to adhere to the legal fiction that there are no choices to be made, success will be measured in securing malpractice protection, and the idiosyncratic encounters of a humane "science" -- in that regard the tension unchanged from the time of Hippocrates -- made an inhumane gesture of mere endurance.

November 3, 2009

And Then the Time Passed, Claude Levi-Strauss: 1908-2009

"Why did I do it? When I work, I suffer moments of anxiety, but when I don't work I'm bored, and my conscience keeps pricking me. Working doesn't make me any happier, but at least it makes the time pass."
--Claude Levi-Strauss, interview.