Introduction: Health Care and Science Teaching

      
 


I.
Not too long ago, my friend Louis told me, "Well, I had my annual checkup yesterday, and the doctor says I'm okay." How many of us have either heard or made similar announcements and felt genuinely good that we or a friend or a loved one has been pronounced "healthy" by a physician? So pervasive has the power of health professionals become that we no longer rely on the information we get from our own bodies and our own sense of well-being to know whether we are in good health. Instead, we need a physician's certification to assure us of our health. So deep is the mystification surrounding health and medicine, and so powerful is the myth of medicine as an omnipotent science, that, despite our misgivings about the quality of medical care and its dehumanizing institutions, most of us still seek out physicians not only to treat us in sickness, but also to validate our health. In no other area of our culture has consumerism gained a more tenacious hold on us than in the area of health. Health has been transformed for us from a state of being to a commodity to be purchased. (For a brilliant analysis of the deep malaise that besets our society as a consequence of the medicalization of life and health, and for a breathtaking panoramic view of how we got there, see Ivan Illich's Medical Nemesis. See, as well, the last chapter of Andre Gorz's Ecology as Politics.) Our dedication to medical consumerism has been historically reflected in the kinds of demands the Left has made for changes in the health care system. For many on the Left, political demands have been limited to calls for broadening access to the health care system by the introduction of some form of "socialized" medicine. Associated with this program for greater distributive justice has been the goal of controlling the extraordinary costs of modem high technology medicine. The underlying assumption has been that what is bad about the health care system is its inequitable distribution of services. It is natural that, as radicals, our response to the sex-, race-and classbiased inequities in the distribution of health care services is one of outrage. Our egalitarian commitments lead us to support struggles for a more equitable distribution of medical services. If only women, the poor, and people of color had access to the same services as the wealthy and if only the costs were not so high, all would be well, we think. We ignore the fact that these same institutions whose services we seek to distribute equitably have expropriated our health, have medicalized virtually all of our normal stages of growth and development, and have made as many people sick as they have cured.
In recent years, critiques of health care institutions have gone beyond the simple question of unequal distribution of medical services. Even within the medical system itself there has been some tendency to criticize and correct some of the more grotesque excesses of the health care system. These tendencies are manifested, for example, in the growth of the hospice movement and in the increasing number of options being made available to women giving birth. The last decade has also been marked by struggles for participatory justice, such as those for community control over health care institutions and resources, and by the establishment (and disappearance) of alternative "people's" medical clinics. On other fronts, struggles around occupational safety and health have intensified and have been accompanied by demands for union and worker control over conditions affecting health and safety in the workplace, and the ecology movement has focused attention on the fact that health depends on an environment increasingly threatened by pesticides, chemical carcinogens, radiation, etc.
However, the sharpest attacks against the tenacious hold which the medicalized health care delivery system has on our lives and consciousness comes from two sources: the growth of the multi-faceted holistic health movement and the growth of the women's health movement. While the holistic health movement appears to be somewhat amorphous and encompasses within it many different tendencies, it does represent an attempt to divest the medical/health care establishment of its sovereignty over health and the treatment of disease. The women's health movement, which is more self-consciously political, has sharpened the focus on the inherent problems of the health care system even more. The basic thrust of the movement, through its educational activity, its formation of self-help groups, and its establishment of women's health clinics, is to demystify women's perceptions of their anatomy and physiology and to give women, rather than the medical establishment, control over their health and lives.
All of these developments --the deprofessionalization of health care; the assertion of individual capability and responsibility for adopting more healthful life styles; and the assumption of individual and collective nonprofessional, informed control over those normal functions of our development and life which have fallen victim to domination by the health care system --are indeed revolutionary in their potential. However, within movements dedicated to fostering these developments, there is also a potential for victim blaming and for deflection from legitimate struggles for distributive and participatory justice. While these movements are helping to demythologize and demystify the nature of health, individual and social, they can also raise consciousness about the fundamental sickness of our society, which is badly in need of radical reconstructive surgery.

II.
No group of radical teachers I know leads lives more fragmented than radical scientists. The gulf between what we do as research scientists and teachers and our political work often seems unbridgeable. American science is an expensive, highly competitive endeavor. "Publish or perish" not only describes the imperatives for achieving tenure, but even more accurately describes the competition for research funds. Due to this fierce competition, teaching (for young scientists especially) is often a secondary activity. Further, there seems to be little connection between the teaching that we do and our politics. The teaching of basic science, given the curricular expectation of covering a defined body of material, is often characterized by appeals to authority; the presentation tends to assert that "these are the facts." Such teaching mystifies science. It obscures that scientists, being human, cannot help but unconsciously reflect the biases and politics of their times. As privileged members of society, they often find themselves defending the social order, cloaking their defense in the language of science and appeals to nature.
For radicals this obviously unsatisfactory situation has led to development of a series of courses (under such rubrics as "Science and Society") in which the main focus is on the ideology and politics of science rather than science itself. Teaching such courses is not without risk for the teacher, who often is looked upon by her or his seniors as lacking seriousness. While the existence of such courses is a significant improvement over the exclusion of ideological analysis from the science curriculum, ghettoizing such analysis inside special courses creates some potential problems.
The first problem is one of audience: These courses often attract primarily non-science majors, and thus do little to challenge the consciousness of future scientists and physicians.

It is not enough to expose the racism, sexism, and classism that underly much of biological and behavioral science, or to draw the connections between much of the work in the physical and chemical sciences and the Department of Defense and multinational corporations. It is as important, if we are to demystify science, to develop the understanding that science --even good science --as a creative human activity has an ideological content.
Second, such courses can easily become arenas in which cynicism, rather than skepticism, about science develops. It is not enough to expose the racism, sexism, and classism that underly much of biological and behavioral science, or to draw the connections between much of the work in the physical and chemical sciences and the Department of Defense and multinational corporations. It is as important, if we are to demystify science, to develop the understanding that science --even good science --as a creative human activity has an ideological content. Scientists, no less than novelists or poets, are storytellers. Their stories are based, at best, on unbiased data obtained by verifiable procedures which are then organized and given meaning by the application of creative imagination.
The third problem with "Science and Society" courses is that they tend to deflect radical scientists from seriously undertaking a revision of courses in which the primary focus is on scientific content. Since the way we teach such courses often perpetuates the myth of a neutral science based upon the notion that only what can be quantified is important, a serious consideration of how to teach basic science is in order. (1931 -2022) taught biology at Tufts University and also directed its American Studies Department, which he helped establish.

Saul Slapikoff
He published Consider and Hear Me: Voices from Palestine and Israel (Temple University Press, 1992) and later developed as a playwright, working with the Underground Railway Theater in Cambridge, Massachusetts. He served for over four decades on the Editorial Board of Radical Teacher.
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