Anxiety in the Age of Trump
Whether or not one was a Donald Trump supporter, the end of the primaries in the summer of 2016 inaugurated a new age of vigilance, anxiety and outrage for Americans. Whether by virtue of Trump’s boorish norm violations, intentionally provocative communications strategy and general emotional dysregulation, or whether due to the near-constant attacks on the Administration’s functioning and legitimacy, a new baseline level of rage and fear took hold in Anglo America and much of the Global North, a pervasive psychosocial state we have yet to shake-off eight years later.
America’s stand-up comics were, for the most part of group of liberals already skilled in mocking and belittling America’s populist conservative movements. And many did a great job of skewering the Trump administration over the president’s apparently unhinged public behaviour and revolving door of officials, each greasier and more bizarre than those they replaced.
But the comedian who best expressed the sense of anxiety that pervaded America was John Mulaney. He offered the following metaphor: “It’s like there’s a horse loose in the hospital… And nobody knows what the horse is going to do next, least of all the horse. It’s never been in a hospital before.”
I quoted that bit many times during Trump’s four years in office and have a few times since, especially as that feeling of anxiety has not gone away, what with the Bumpkin Putsch, followed by the failed impeachment, the prosecutions, the efforts to disqualify Trump based on a crime the impeachment trial had acquitted him of. The feeling that there is a horse loose in a hospital has never gone away.
But the reason this description of the situation plays so well with people like me who were steeped in progressive culture is that it plays to an unconscious belief that society, as a whole, is just one gigantic hospital.
The Rise and Fall of the Giant Agora
At the zenith of neoliberalism in the late 1990s, no matter what party one supported at election time, no matter what church one attended, no matter where one was located, socially, when neoliberalism enjoyed cultural and ideological hegemony, we saw society as a gigantic marketplace. The agora had swallowed the whole city. The schools, the hospitals, the council chambers, everything existed in the context of the marketplace. If we wanted to say that something was good, we looked around for words of praise and said things like “profit,” “efficiency,” “competition,” etc.
But as we entered a period of socio-political realignment in the early 2010s and the commissar class who dominate the Pharma and Data sectors began to eclipse the neoliberals as our cultural hegemons, our understanding of the world began to shift away from seeing everything through the prism of the market. Covid and the opioid crisis helped in this shift but the re-categorization of all pain and unpleasantness as “trauma,” and all responses to it as “triggering,” was just as important.
What had begun in the 1990s with the huge-scale prescription of third-generation SSRI anti-depressants reached its culmination as we came to redefine feeling bad as inherently problematic. Our identities began to shift, too. Those who have embraced the new progressive culture of the commissar class, have come to engage in self-fashioning behaviours of self-diagnosing oneself into a series of pathologies, with the assistance of the ubiquitous online psychiatric diagnostic quizzes, funded by a pharmaceutical industry eager to receive more orders for psychiatric drugs.
In British Columbia, the government’s policies of steadily reducing and restricting citizens’ access to free medical care have resulted in the normalization of psychiatric self-diagnosis, presented by telephone during ten-minute appointment telephone windows at clinics that charge cold hard cash to see a physician in person. More and more British Columbians are on speed as internet ADHD self-tests have come to be accepted by the province’s overloaded clinics and Adderall and other amphetamine prescriptions are dispense by phone and online. One doesn’t need to tell the government one is an addict to be prescribed meth substitutes, although that works too; one can just say that it’s tough to concentrate, what with a horse being loose in the hospital.
But it is not just during a doctor’s appointment that your average progressive British Columbian announces a set of psychiatric self-diagnoses. This is how people who have adopted the culture of the commissar class talk about themselves all the time; within a few minutes of meeting someone at a fashionable party, one begins to hear one’s new acquaintances list of mental illnesses, even before they get to their preferred pronouns.
Indeed, psychiatric self-diagnosis has become the linchpin of self-fashioning in the progressive world. As being unique and special in the sight of God is not a culturally or emotionally available option, the language one uses for both describing one’s uniqueness and begs not to be bullied in this, one of the most judgemental and predatory social orders of recent times, is to “identify into” a series of neurological disabilities and sexual fetishes.
The term “neurodiverse,” one that initially made sense only at the population level, has become conflated with “neurodivergent” and applied at the individual. If one can no longer be unique in the sight of God, one can at least be unique and special in the sight of an imaginary all-seeing doctor.
That is because what Mulaney was telling us is that we have stopped believing that society is a gargantuan, all-encompassing marketplace and has become one huge world-containing hospital.
However rational, well-intentioned and even life-saving Covid policies were, when the state began to regulate the size of the crowd you could meet for drinks, have over for dinner, even host at a backyard barbecue, a consequence was that the hospital made your home one of its rooms, your street one of its wards. The reason we have re-described ourselves as a bag of diseases and other conditions necessitating medical intervention is that we have accepted the logic of the commissars, that society is now an all-encompassing hospital.
Brad West and Doing Crack in the Hospital
It is in this context that we must approach Port Coquitlam mayor Brad West’s recent interview with the Vancouver Sun’s Vaughn Palmer. In response to the BC government announcing a review of its new policy of letting hospital patients carry weapons and buy, use and sell illicit drugs while in hospital, West suggested that the government could save its money. His review was done, “In a hospital, there’s no weapons and you can’t smoke crack or fentanyl or any other drugs. There you go. Just saved God knows how much money and probably at least six months of dithering.”
What baffled those outside the Progressiverse was how this could even be a thing, how it was that, in an environment where powerful drugs are being administered by highly trained professionals, trained in predicting and managing drug interactions, how addicts shooting up street drugs of unknown provenance or purity could possibly be remotely safe and not undermine the precise care they are receiving. How on earth did we get here? How could one reasonably administer opiate pain relievers when patients were also self-administering unknown types and quantities of opiates?
And weapons!? How could it be safe for people doing central nervous system stimulants and undergoing intensive, painful and disorienting medical treatment to be armed with hunting knives and boxcutters?
The answer is simple: if society is a hospital then the hospital is society.
And in the giant society-spanning hospital, everyone is a doctor or a patient, and as evinced in the increasingly ubiquitous signage about not upsetting and “triggering” receptionists and medical personnel at clinics, both.
If everywhere you go is the hospital, then whatever you are free to do in the world, you are, axiomatically, free to do in the hospital because if the world is the hospital then the hospital is the world.
Generally, when a society idealizes something, whoever or whatever is being idealized is actually being singled-out for special punishment. No society idealizes female virtue like Saudi Arabia or Iran. Similarly, our society grows ever more shabby in its treatment of people genuinely neurologically disabled. Autistic people have been pushed out of self-advocacy organizations and the public square by people who are merely a little quirky or socially inept. Their spaces have been invaded and their silencing has enabled, as Hillary Cass’s review most recently pointed out, a mass sterilization campaign to be waged against autistic youth in the name of genderwang.
Similarly, mental healthcare has all been all but withdrawn from people truly disabled by addiction and madness. Treatment has been replaced by “supportive housing” and tent cities. It seems that the only right of the addicted and insane we defend is their right to be miserable, to sleep rough, to defecate in the streets, to shoot up in parks and to scream at passers-by. And there is a logic to this too. The more ill health there is, the more society really does seem like a gigantic understaffed hospital.
Medicalized Societies Are Sick Societies
We are not the first society to decide to see everything through the prism of medicine and disease. In recent studies of Franciscan and Jesuit catechisms written in Iroquoian languages, we find that the societies embroiled in the “mourning wars,” of the seventeenth and eighteenth centuries, wherein Huron and Iroquois warriors engaged in endless capture-oriented military campaigns to replace population lost to smallpox and other Eastern Hemisphere diseases also saw the world in medical terms.
Almost every positive thing Christian missionaries promised new indigenous converts was described in the Iroquoian languages, as a form of medicine. Every good thing in the universe, grace, salvation, sustenance, community was presented as “medicine.” That is because a society only decides it is a gigantic hospital if those living therein know that sicknesses of body and mind have metastasized into a social sickness, a society-wide cancer, in the case of the Iroquois, an epidemic not just of smallpox but of something they called “false face disease,” a consequence of centuries of continuous war, disease and martial law.
The way out of such a society, such a state of being is not more medicine. It is not categorizing more things as sickness and categorizing more activities as medicine. Prescribing chemical castration and lobotomization drugs to children may be called “medicine” but there is nothing healthy about it. Offering to murder disabled, homeless and depressed people through the MAID program is called “medicine” but it is anything but. Amputating people’s healthy body parts or adding prostheses and fake orifices so they can better resemble the Japanese cartoons they believe to be their “true selves” is not medicine by any reasonable definition, nor is secretly prescribing fentanyl to teenagers as part of some sort of Opposite Day “harm reduction” plan.
You see: the thing that makes our society sicker, more dangerous than the late-stage Iroquois Confederacy is that a hospital is a hierarchical, authoritarian bureaucratic institution that conflates power, expertise and medicine into a single authoritative principle. In this society, whatever the state does, is, by definition, “medicine,” irrespective of whether it makes you more or less healthy, irrespective of whether it makes you suffer, irrespective of whether it even kills you.
If there is a solution, I would suggest we can find it in the Tao Te Ching:
“He who is sick of sickness is well.”
