02 December 2007

The "Ah, Tennyson" moment and the postmodern professional

As a young man Alfred Tennyson was afflicted with a painful attack of piles. Accepting advice, he visited a youthful but well-known proctologist and was so successfully treated that for many years he had no further trouble. However, after he had become a famous poet and had been raised to the peerage, he suffered a further attack. Revisiting the proctologist, he expected to be recognized as the former patient who had become the Poet Laureate. The proctologist, however, gave no signs of recognition. It was only when the noble lord had bent over for examination that the proctologist exclaimed, "Ah, Tennyson."

I treasure this little anecdote, not only because it pokes wry fun at poets and proctologists alike, but because, parable-like, it illustrates a truth about the human condition. Part of its humour arises out of the absurdity that the clinician's concentration on his work should be so complete as to preclude his recognizing the great poet until the baronial drawers have been lowered. There is also, of course, the universal human delight in scatological jokes — the more irreverent the better, since everyone, even an aristocrat, has to sit on the throne.

But there is more to it than that. Implicit in this compelling but elusive narrative is a sense of how blind we can be to anything but the piles of work before and behind us, and how neglectful of the clamouring realities staring us in the face. We may laugh at the single-mindedness of Tennyson's doctor, but librarians are no exception. Squirrelling away at technology, too busy to think, obsessed with getting to the bottom of our own specialties, we suffer a sort of mental constipation, thinking that what we do is an end in itself while we miss the obvious. We are all guilty of this. Librarians can be as heedless as the most absent-minded of professionals.

The impending demise of Canada's leading consumer health information website gave me the opportunity to reflect again on professional short-sightedness and anal-retentiveness. What should librarians, particularly health librarians, think about the motivations and predilections behind the Conservative government's decision to cut funding for the Canadian Health Network? "Conservative" hardly seems to be the appropriate word for what is at work in Ottawa. Au contraire, axing CHN is just one part of a broader, quite radical set of imperatives, it seems to me. As Carol Goar puts it in the very first sentence of her Toronto Star article of November 16, "This is how a nation's social infrastructure is dismantled."

What should we do? Simply wring our hands, adjust our blinkers, and continue working on our promotion? Even the bureaucrats were fumbling for excuses. Shutting down the network was a "very difficult decision," said Alain Desroches of the Public Health Agency. "The agency will continue to look for effective and innovative ways to provide Canadians with high quality, credible information through other means." What, pray tell, might those other means be? Given a government whose primary affinity is with the catechisms of the market, I think we know what to expect.

In fact, Health Minister Tony Clement launched a new website, Healthy Canadians, in October, to provide users with "easy access to Government of Canada health-related promotional campaigns" — the government's children's fitness tax credit, its revised Canada Food Guide, its toy safety tips, its latest product recalls, and its healthy pregnancy guide — all designed to promote the government's vision of what constitutes an active, well-balanced lifestyle. Pregnancy OK, the kind of sex that doesn't result in pregnancy unmentionable. The website looks more like an election ad than a serious source of information for the general public, a feel-good exercise that has been hastily thrown together. What's being promoted is not health but the government itself. This reminds me of the ridiculously widespread use by television networks of the "coming up" promotional advertisement. In addition to being subjected to their incessant commercials, we now must endure frequent and detailed announcements of what they will be telling us later, to the point that a program like CNN news feels like one long advertisement for itself, punctuated regularly by lengthy advertisements for corporations which then finance CNN's own self-promotion. Lost in the midst of this tiresome cycle, this hollow, echoing Lotos-land, is any sense of what is actually occurring in the real world.

The centralization of health information in one place is a good thing. That was the vision behind the Canadian Health Network. Healthy Canadians is something different. As Carol Goar remarks, "What's missing from the new database is any reference to the links between health and the environment, disease and poverty, or violence and gun control. Nor does it touch sensitive topics such as abortion, genetically modified foods or sexual abuse. It completely overlooks mental illness. In contrast, the Canadian Health Network is all-encompassing. It looks at controversial questions from all sides. It is constantly updated as new knowledge becomes available."

What will happen after all the effort put into CHN? Inevitably we are drawn to rationalizing. Losing the program won't be the end of the world. Sad, but true. Canadians will make use, as they already do, of the rich resources of MedlinePlus from the United States and the multitudes of consumer health websites in many languages that have emerged on the web. The CHN contributors and sustainers will find other ways to reach their audiences. Somehow we'll cope. But here is the heart of the issue. Carol Goar again: "[T]he idea of a comprehensive, national database, built and maintained by the best people in their fields will wither. The belief that Canadians can work together, with the government providing a common forum, will wane. A promising experiment will die. And the government will look for another non-essential program to cut."

As information providers (and supposedly civilization's guardians), librarians are caught up willy-nilly in this ongoing ideological demolition job. Libraries, as a vital part of the civic commons, are not immune to the kind of calculation that is likely to erase the Canadian Health Network. It has been said, tongue lodged firmly in cheek, that nothing is so useless as a general maxim. But let me propose a new axiom that seems to me as firmly based as the laws of thermodynamics. Postmodernism is now driving politics as surely as the desert wind is dry. We are sliding into the postmodern, post-civil world; we're already there actually, but the process is so subtle that, like desertification in the Sahel, we see what's happening only with hindsight.

However, alternatives are still possible. Nothing is completely foreordained. Needless to say, there are many in this country who do not approve of this or other actions of the government that threaten the public good. The "Friends of CHN" have formed, one of their first initiatives being to start a petition, both in English and in French, demanding that the Canadian Health Network's funding cut be rescinded, and that full, stable funding be restored immediately to allow the program to become the kind of national resource it was meant to be. Letters are being addressed to the Prime Minister and the Minister of Health, people are organizing, bloggers are commenting. But librarians need to do more. So far both the Canadian Library Association and the Canadian Health Libraries Association have been silent. I hope to see some mention of this issue appearing on their websites soon.

To many, what is happening with the Canadian Health Network may seem of little consequence. "Let it go," they'll say. "The market will see to our needs. For that matter, let libraries go as well. Don't we have Web 2.0?" To such a glib proposal I would reply in this way. Once the foundations of the civic commons are removed, stone by stone, in a long process of disintegration of which the quiet removal of CHN is just one episode, there will be little left to remind us of the public polity that was. It will have been replaced by another, less polite, reality. Libraries are not exempt from this process. The new facts on the ground, the only essentials, will be commercial ones, such that culture will have become coextensive with the economy, and consumption will have successfully made itself into an immutable law. Civil society, in my apocalyptic vision, thus undergoes a slow dissolution into a wide-open commercial sphere, a jagged, desolate no-man's-land of receding equality, plutocratic machination, anonymous marauding, and deregulated violence — all garishly backlit by vacuous spectacle, the saturating ubiquity of wall-to-wall ideology. Think of the dystopian science fiction of William Gibson. In this new cultural logic, as Fredric Jameson has maintained, Utopia's deepest subject thus turns out to be precisely our inability to conceive it, our incapacity to produce it as a vision, our failure to imagine what could be. Alternatives become unthinkable. Life becomes, in Adorno's words, the ideology of its own absence.

As the Social Justice Librarian puts it:

When a pro-privatization government cuts national funding to social infrastructure and, at the same time, turns a blind (or at least feeble) eye to corporate challenges to public health and social policy regulations … well, I guess that’s where all that information literacy training we librarians are always pushing comes in. Because health information with a profit-motive is clearly not in the public interest. But without a not-for-profit health education, will we recognize it when we see it?
Speaking of the unthinkable, in her new book, The shock doctrine: the rise of disaster capitalism, Naomi Klein offers a revealing anecdote about her experience at a New Orleans hospital in the aftermath of Hurricane Katrina. A car accident leaves her with minor, but painful, injuries. Conveyed by ambulance to Ochsner Medical Center, "the most modern and calm hospital I have ever been in," Klein receives courteous and comprehensive care. She is amazed by the immaculateness of the wards and the quiet efficiency of the staff:
To a veteran of the Canadian public health care system, these were wholly unfamiliar experiences; I usually wait for forty minutes to see my general practitioner. And this was downtown New Orleans — ground zero of the largest public health emergency in recent U.S. history. A polite administrator came into my room and explained that "in America we pay for health care. I am so sorry, dear — it's really terrible. We wish we had your system. Just fill out this form." (p. 489)
Klein strikes up a conversation with an intern who has kindly slipped her some painkillers since the hospital pharmacy is locked up tight for fear of looters. From him she learns that the Charity Hospital, which serves the city's poor, has been heavily damaged. Then comes the "Ah, Tennyson" moment. "They'd better reopen it," the intern says. "We can't treat those people here." Klein comments:
It occurred to me that this affable young doctor, and the spa-like medical care I had just received, were the embodiment of the culture that had made the horrors of Hurricane Katrina possible, the culture that had left New Orleans' poorest residents to drown. As a graduate of a private medical school and then an intern at a private hospital, he had been trained simply not to see New Orleans turned into a giant emergency room: he had sympathy for the evacuees, but that didn't change the fact that he still could not see them as potential patients of his. (p. 490)
It is this inability to "see" something so obvious to others which, for me, characterizes the blinkered postmodern professional. We have here a terrible disconnect between practice and politics. Here is a promising young physician who cannot, or will not, allow himself to think through unacceptable social conditions, who is content, like Tennyson's proctologist, to focus on what he has been programmed to do while missing the obvious — and losing all the compassionate poetry of life. How many librarians, how many health librarians, are also without eyes to see? In what Lotos-land do we live and lie reclined, careless of mankind, attending only to our objects of professional interest? When shall we have our next "Ah, Tennyson" moment?

The Lotos blooms below the barren peak:
The Lotos blows by every winding creek:
All day the wind breathes low with mellower tone:
Thro' every hollow cave and alley lone
Round and round the spicy downs the yellow Lotos-dust is blown.
We have had enough of action, and of motion we,
Roll'd to starboard, roll'd to larboard, when the surge was seething free,
Where the wallowing monster spouted his foam-fountains in the sea.
Let us swear an oath, and keep it with an equal mind,
In the hollow Lotos-land to live and lie reclined
On the hills like Gods together, careless of mankind.

Alfred Lord Tennyson, from The Lotos-Eaters: Choric Song