Seductive repetition

This holiday season, I elected to take a digital sabbatical from 13 December to 2 January.

Returning to the healthcare conversation after three weeks away has been… a little odd.

The thing that strikes me most forcefully is our apparent willingness to resume the habits and behaviours we manifested previously without stopping to question what they actually achieve, and whether we can do better.

Time away from digital environments offers the welcome opportunity to reflect on the diligent futility of much that we do.

So many of our activities seem expressly designed to achieve objectives we have set internally rather than serve the external needs of those we serve, and often they take us farther away from rather than closer to the communities of interest which are important to us.

The engrossing nature of working and living in social environments has impacted upon the amount of time that I personally have spent reading and contemplating. I suspect I’m not alone in this regard.

A boundless potentiality inheres within the social web to make us more insular rather than more open-minded.

We may become more connected, but we may also become less mindful: less willing to interrogate existing states of being and organisational arrangements, less capable of formulating critical responses to ideological concerns, more likely to consider ourselves to be collectively traversing a flat, unproblematic, mutually acceptable terrain in the name of the Greater Good towards that place where Progress resides.

I’m troubled by this, because it patently isn’t true.

One case for the prosecution would appear to me to be the fact that to give any credence to the possibility of employing Google Glass in a healthcare setting at present is ludicrous. Like discussion of the quantified self and the iPad before them, the interminable trading of opinion on possible applications for a technology that is unusable in its present form does not seem like a great use of our time if we’re interested in improving health outcomes — and our time is so very short.

The social health conversation too frequently conducts an easy trade in difficult propositions.

We tacitly assume a universal purpose to the work that we undertake as though we were connected in a more substantive way than the digital tools that we use allow us to be.

In doing so, we are at risk of excluding the very things we wish to promote.

Judith Butler reminds us that ‘that which remains “unrealised” by the universal constitutes it essentially’. The reinscription of a hierarchy of authority in healthcare that seeks to privilege the primacy of technology in much the same way as it formerly yielded to the pre-eminence of healthcare professional opinion is likely to repeat its principal mistake, namely to overlook the desire of the patient.

As we return to our work in 2014, let us guard against unwittingly reinvesting ‘the exclusionary function of certain norms of universality’.

Let us resist the urge to resume the seductive, destructive repetitions that ‘look like work’ in our region of healthcare’s topography and acknowledge the challenge that has emerged ‘from those who are not covered by it, who have no entitlement to occupy the place of the ‘who’, but nevertheless demand that the universal as such ought to be inclusive of them’: patients.

Citation: Judith Butler, ‘Restaging the Universal: Hegemony and the Limits of Formalism’, in Judith Butler, Ernesto Laclau, Slavov Žižek, Contingency, Hegemony, Universality (London: Verso, 2000) p. 39

2 thoughts on “Seductive repetition

  1. Welcome back Andrew with your reflections.
    All I can say indeed, at the same time however, underlining the need for an add on to your reflection: the need for change is (more than) apparent. Not in the sense of applying technologies, but in the sense of (cultural) changing our way of thinking about care and what its basic starting point would be. The medical perspective, like the technological perspective on “care”, or better phrased, “..trying to cope and develop with one’s health conditions”, is just one of the viewpoints on what we have become to know as “the health care system”.
    The issue here is how much medical perspectives, patient perspectives and organizational and financial perspectives on “health care” have actually been the same since the early days of “caring”, never to change fundamentally until today, I hope. The “system”, in essence still is not integrated, not balanced, and certainly not patient directed. Every stakeholder still starts with doing what one sees as one’s proper task in the system, on its own. The sum of all those does not, alas, bring forward an efficient, as we already know, but also not an effective (enough) outcome.
    Let’s hope that in the sense of “disruptive” will force the “system” in 2014 more substantially to begin to change fundamentally.
    great to have you back, digitally 😉

  2. Andrew, this is a tour de force and certainly your break seems very reflective. I also like Robs comments as well. I certainly feel that we are at a cross roads around how these new technologies are being incorporated and social habits are slowly changing. There seem to be many forces at work either not wanting to change or manage change with organisation and (yes) individuals own interests paramount. You rightly conclude that the optimal system still evades us – even defining the objectives seems a way off. In the meantime our conversation online needs to transcend the trivial and gossip (yes I am guilty) and focus on how individuals capabilities can be used to build what our future generations deserve.

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