Birth of the Clinic
Librarian note: an alternate cover for this edition can be found . In the eighteenth century, medicine underwent a mutation. For the first time, medical knowledge took on a precision that had formerly belonged only to mathematics. The body became something that could be mapped. Disease became subject to new rules of classification. And doctors begin to describe phenomena that for centuries had remained below the threshold of the visible and expressible. In The Birth of the Clinicthe philosopher and intellectual historian who may be the true heir to Nietzsche charts this dramatic transformation of medical knowledge. As in his classic Madness and Civilization, Michel Foucault shows how much what we think of as pure science owes to social and cultural attitudes -- in this case, to the climate of the French Revolution. Brilliant, provocative, and omnivorously learned, his book sheds new light on the origins of our current notions of health and sickness, life and death.
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- Foucault? In my mind he's a conservative. His early books (Discipline and Punish and Birth of the Clinic) are brilliant and cover the ground that anarchists like Murray Bookchin do, debunking them all the way. Clinic also explains why health care is never going to seem affordable because, even if Bill Gates could afford CABG surgery and you couldn't, he's got to get millions of people to get the surgery so that the techniques are developed enough that the survival odds are good.
- One way to think about feminism is as a literary genre in the sense that texts are frozen in amber in the library at your nearest Uni.
It follows the same track as anything (e.g. Twitter) in that the first feminists come across as much better than later feminists -- early adopters are "better" than people who come late, plus groups develop pernicious tendencies over time.
Up to 1970 or so feminists writers are elite, but soon you start to get "zines" where women "bitch" about their problems after getting a good dose of Trotskyism (and later Americanized French Theory [1]) to derange their ability to communicate. By the late 1980s, realizing that they're not speaking to young women, they start to pander to young women so the mainstream is stuck acknowledging the "empowerment" of being an OnlyFans performers but not recognizing the downsides. There has been a conservative countercurrent of plain-speaking academics such as Eva Illouz but way too many academics speak to each other in the obscure gallicized language of American academia.
[1] Oddly, French Theory is big in Japan like Freud is big in Japan, not just among academics but in wider popular literature. Translations from French run into the odd problem that quotidian (everyday) words like spectacle (show) and ensemble (group, as in a rock band or a meal bundle at a fast food restaurant) are $10 words in English. The writing and translation of early Foucault are great (drop what you're doing an read Discipline and Punish or Birth of the Clinic) and I've got a soft spot for Baudrillard between System of Objects and Simulacra and Simulation not to mention Alain Badiou's perfection of Derrida's strategy of Being and Event which spoke to me in my Ontology2 phase, but so much of it is unreadable. On the other hand, Japanese books like Beautiful Fighting Girl by Saito Tamaki make Lacan almost make sense.
- Nice! I wouldn’t describe the early Foucault as ‘rebarbative’, the common translations of Birth of the Clinic and Discipline and Punish are a pleasure to read although the volumes of The Uses of Pleasure are not —- he had a little too much exposure to Derrida. [1]
But I’ve been saying that LLMs would bring a structuralist revival here for years, long before people started saying that on Just Wrong and we are seeing real ‘authors’ pick it up.
As I see it, the idea that ‘X has a structure of a language’ collapsed when Noam Chomsky introduced the idea of poverty of the stimulus (you aren’t exposed to enough language to learn grammar from first principles) and the further failure of Chomsky’s theory to be the basis of language technology (40 years post Zork we have Inform 7 and Attempto Controlled English)
We were all sure the language instinct was a peripheral added to an animal that already had a theory of mind and all that…. But all of a sudden you could train an LLM on a pile of text and it did what Chomsky said was impossible and all of a sudden language has the structure of a language and structuralism is back baby!
[1] Hate Derrida? Try Badiou. He plays the same game but with impeccable precision, you can’t ever say that he doesn’t understand the texts that he deconstructs and boy does that make some people mad…
- Look at Foucault's book "Birth of the Clinic" to see why the wealthy need less wealthy people to get health care to drive the volume that makes possible the services that the wealthy can afford.
For instance, if you were a billionaire maybe $1,000,000 for a coronary artery bypass operation would seem like a good deal.
Doing those operations in volume lowers the cost but it also makes it possible for doctors to get experience that makes the operations safe and effective. Studies have shown that the main factor for survival in CABG surgery is how many operations are done a year by the doctor and the clinic.
Similarly, you have to treat thousands of people to prove a drug is safe and effective. You just couldn't have advanced treatments for the ultra-rich without these treatments being developed and tested on a large volume of less wealthy people.
- 1/3 of that is health insurance.
Health insurance is a weird one because even though people think they want it when "daddy" is paying for it, if they got to trade health insurance for something that cost about as much such as
* two months of vacation a year * free housing for life, etc.
many would pick the later. Michael Foucault, in his "birth of the clinic" points out that rich people who could afford (say) Heart Bypass Surgery couldn't get it unless somehow other people who couldn't afford the surgery could get it, because otherwise the surgery wouldn't be done often enough to not be a death sentence.
- I think this article is less about "normal" and more about "average" person. The history of normality and curing/fixing abnormality has been dissected by Michel Foucault's "Discipline and Punish: The Birth of the Prison" and "The Birth of the Clinic: An Archaeology of Medical Perception".
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