Jake Meador on Ivan Illich
Thinking about "Technopoly" & iatrogenesis
Hey friends, I hope you’re well! A quick programming note off the bat, I realize my posts have been irregular this spring, and they will probably continue to be. With the pace of life of late, the rate I’ve been creating these has felt helpful and manageable for me, so thanks for bearing with me and tuning in when able.
Thanks to those who send me encouraging notes quite regularly; I appreciate them and am thankful to know my musings are helping you!
Today, I’m going to drop a bit from a new book by Jake Meador that I read recently. In this excerpt, he grapples with the work of Ivan Illich in a way that I found pretty interesting, and I hope you will grapple with it as well.
In his book Deschooling Society the Czech tech critic Ivan Illich argues that much of our experience of the world today is obstructed and conditioned by institutions. He refers to this as the institutionalization of values. Illich was particularly concerned with education. Writing in the 1970s, he argued that schools have transformed something as expansive and central to human experience as learning into a kind of mechanical process.1
This is, of course, a notion we’ve dealt with before. But before I annotate too much, let’s keep going.
What should learning be? According to Illich, learning is what happens when we open our eyes to the world and begin to make sense of it. We hear the bird's song and then learn to name it: cardinal, mourning dove, blue jay. We see something gently falling from the sky and then learn its name-snow-and begin to play in it. Education helps us to open our eyes to the world with greater knowledge, which in turn helps us to respond to the world with greater care, to interact with it in ways that tend toward health and flourishing…2
So, a vision of the good life. Education should point us to a solid understanding of pursuing “health and flourishing,” giving us the tools to make sense of the world and pursue meaningful ends. But of course, this isn’t the education system we find ourselves with these days. Where did we go wrong?
Illich uses the idea of "iatrogenesis" to explain the problem. Originally, iatrogenesis referred to medical problems caused by doctors or nurses attempting to cure a patient. In contemporary terms, the all too common story of a person being severely injured and then becoming addicted to painkillers during their treatment could be seen as an example of iatrogenesis. Likewise, in society, iatrogenesis occurs when an institution that is meant to promote some desired good comes to do greater harm in the pursuit of that good. How does this happen? Illich uses the example of two "watershed" moments in medical care to explain it.
The first watershed comes when a new technology emerges and produces a rapid and significant improvement in quality of life. This happened in the first half of the twentieth century in American medical care as vaccines eradicated once devastating diseases and the discovery of penicillin made it possible to treat many common illnesses more effectively. But then a second watershed comes when the original goal is lost and the technology or institution becomes self-referential, judged only by how well it serves its own ends…3
This, of course, is another idea we’ve encountered before. There is a self-referential tendency here that pulls us into unending loops.
…once we pass Illich's second watershed, an institution is no longer judged by whether it serves society in some real, tangible way in keeping with its original intent. Rather, it is judged by standards it has defined for itself. We can see a similar process in the economy: The American economy was, in one sense, booming throughout the 1980s and 1990s. But the boom didn't necessarily mean higher wages for average American workers or an improvement in the quality of American life as good work was done in service of neighbor. All that a "booming economy" meant was that the stock market was healthy and people who had invested in stocks were doing well for themselves. The actual relationship between the economic growth of that era and the status of ordinary American workers was tenuous at best.
Likewise, we can see the process of iatrogenesis in the American education system. Students in America will receive a standardized curriculum and a standardized reading list (consisting almost entirely of textbooks). We are taught that the purpose of our education is to equip us to pass standardized tests before passing into an adulthood of standardized work... And so educational institutions are no longer evaluated according to whether their students graduate with a love of learning, a delight in the world, or a desire to cultivate their minds. They are, rather, judged by test scores, graduation rates, and, for colleges, job placement rates.4
So, how should we respond to this? We can do certain systematic things to address how our education system works or how our healthcare system deals with pain. But I think a more significant point is for us to all collectively realize the tendency for means to become ends broadly and constantly evaluate ourselves and the systems within our influence on that front. We can recognize that systems' core tendency to become self-justifying in this way and that really, anything we do to confront that will likely raise resistance from the system. But that doesn’t change the underlying fact that what we are striving for here is indeed the good life and our and others’ ability to be meaningful agents of it in this world.
That’s a heavy weight and can be overwhelming. But today, start with what’s in front of you. How can you advocate for the good life where you find yourself?
And with that, thanks for reading. See you again soon.
What Are Christians For?, 85-86
What Are Christians For?, 86-87