Professional Documents
Culture Documents
Prognosis Dialectics Mutation
Prognosis Dialectics Mutation
'LDOHFWLFV0XWDWLRQ
$QJHOD0LWURSRXORV
Access provided by University of Western Sydney (18 Nov 2014 16:05 GMT)
Eric Cazdyns The Already Dead ends on that most perilous but enigmatic of notes, a deep breath suspended in the time and place of letting
go while still holding on, bargaining between terrors and desires, tarrying with the fear of dying for long enough that, just maybe, it becomes
something else. For Cazdyn, that would involve a disposition no longer shaped by the state and, indeed, its hysterical desire for salvation and cure, without abandoning time to an interminable calculable
rhythm (204). This is the inconclusive insight of The Already Dead, an
aporia, if you will. What other kind of conclusion could there be? If this
is not necessarily the condition of all chronic or acute illnesses, I would
agree that this tempo may well describe a crisis that can alsopartic
ularly in the case of diseases whose treatments can be ongoing but
uncertain and ambivalent, such as cancerbecome a grueling tempo
without any apparent respite. According to Cazdyn, this is the deWning characteristic of a new chronic, a mode of time that cares little
for terminality or acuteness, but far more for an underlying present
that remains forever sick, without the danger of sudden death (8). He
deWnes this temporality, which he considers to be both progressive
and debilitating, as an existential mode that privileges management
over change and holds fast to rigid continuities while walking only with
the most tentative and straightforward of steps (17).
In Cazdyns book, the promise of a cure and the routine management of disease are juxtaposed and entangled. These are the organizing
Cultural Critique 88Fall 2014Copyright 2014 Regents of the University of Minnesota
204
Book Reviews
concepts of the text. Throughout The Already Dead, he sets management and cure apart and together; maps that distinction onto that of
reform and revolution; brings it into a conversation with theorists such
as Slavoj iek, Alain Badiou, Gyrgy Lukcs, Kojin Karatani, Frederic Jameson, Michael Hardt, and Antonio Negri; but, above all, retraces
the thematics of cure and management through psychoanalysis. There
being no cure, as yet, in Cazdyns account the Already Dead shufXe
among versions of disease management or fall into the cracks between
them. The walking dead, as it were. In his view, the antinomy of cure
and management feels a whole lot like having to be more or less sick
without ever being cured, much as one might feel reforms are quantitative degrees of better or worse with no prospect of revolution on the
horizon. But I am not so sure. It seems to me that the prevalent methodological options Cazdyn sets outnamely those of immanentist and
dialectical approachesare both interior to a Wnite history of medicine
and science, including the science of revolution, but in no way do
they exhaust that history. Simply put: quantitative understandings of
pathology remain perturbed by the individual case, just as any dialectical or antinomial schema will be fraught by that which is in excess of
any putative epistemic whole.
The contrast between reform and revolution, understood as a distinction between quantitative and qualitative temporal change was signiWcant to a dispute within ofWcial Marxism in the early twentieth
century. I think it could have done with some unpacking. Taken from
the title of a pamphlet by Rosa Luxemburg, the opposition of reform
and revolution has long informed the politics of the Third and Fourth
Internationals, of Leninists and Trotskyists respectively. Cazdyn notes
that Hardt and Negri are loath to accept the easy distinction (Cazdyn,
56). He might have added that this is because Hardt and Negri are the
least Leninist of the Marxists he admits to his theoretical frame and,
more so, because Negri in particular was inXuenced by poststructuralist
philosophies of science in France, such as those of Guattari, Deleuze,
and (less positively, but still) Althusser. In Cazdyns usage, the political concept of a cure aligns it with a voluntarist and evental deWnition
of revolutiona deWnition whose historical speciWcity, inasmuch as it
is not rendered as such, presents as a generalizable desire. In this Wrst
instance, it erases what Paul Mattick called the difference between
[the] jacobinical and the truly proletarian idea of the world revolution
(5) that exempliWed the divergence between Lenin and Luxemburg. Yet
the Leninist assumption that revolution involved intentionwhich is
to say, the victory of a true consciousness over a false onecould never
give a plausible or critical account of its own history, including Lenins
embrace of Taylorism (otherwise known as scientiWc management)
in the factory, or the Bolsheviks adherence to the form of the nationstate and socialism in one country, any more than it has been able to
offer a critical analysis of the impact of quantitative theories of disease
on the temporal phenomenologies of medical and clinical practices.
Moreover, in Luxemburgs text the salient temporal concepts are not
the decisionist ones of revolution contra reform, as Lenin deWned it.
Despite the title of her essay, Reform or Revolution, the pertinent temporal concepts in the debate between Luxemburg and Edward Bernstein were those of evolution, crisis, and adaptation (Luxemburg). I
am not suggesting that either Luxemburgs, Bernsteins, or Matticks
arguments should or could be uncritically accepted. They are all open
to critical appraisal on a number of counts.
Instead, I would like to illustrate the extent to which the seemingly inevitable or necessary aporetics of The Already Dead (suspended
within the oscillation between pessimism and optimism, or reform and
revolution, management and cure, quantitative and qualitative epistemologies, and so on) has been made possible by the elision of an entire
history of critical debates around (not reform versus revolution, but
what I would characterize as the paradigm of) continuity and mutation
from the books philosophical and political canon. It is not that those
theories are nonexistent. They are present, after a fashion; not least in
Cazdyns book. Luxemburgs emblematic discussion of reform and revolution is a case in point. However when they appear, they do so as
either dialectical swing emptied of reference to its own complex and
Wnite history (including that of Luxemburg herself), or as the phenomenology of an unperturbed immanence. What results is a recursive, selfsame tempo without signiWcant discontinuities between, say, Luxemburg
and Lenin, or (germane to an analysis of both medicine and politics)
between the understanding of Marxism as a science of revolution in
the late nineteenth and early twentieth centuries and critical theories
of science (and medicine) since that time. While Luxemburg and Lenin
differed over the autonomy of the political (over the extent to which a
Marxist science could claim to be unaffected and therefore assume the
205
206
Book Reviews
207
208
Book Reviews
quickly becomes apparent that along with the increasingly global reach
of pharmaceutical companies, laboratories, and online networks of more
or less self-organized patients, lives are wrought by the vast and incremental differences between states when it comes to access to health
care, drugs, information, treatment regimes, welfare, insurance, labor
markets, and, not least, the criterion of medical admissibility in migration and citizenship laws. Cazdyn Wnds himself denied permanent residency, as so many have been and continue to be, on medical grounds.
I was being treated like a felon, one whose crime was getting cancer
at the wrong time (101). And, it might be noted, in the wrong place.
Cazdyn also takes us through some of the genealogical conditions of
citizenship. Writing of the selection of citizens and visa applicants on
the grounds of medical admissibility, he writes that the normative
family has attained a legitimacy from the nation at the very moment
when other kinship practices and social relationships are emerging
(stoked by globalization processes) and challenging the traditional familys dominance (136). I am as unclear as to the reasons for Cazdyns
association between globalization and nontraditional forms of kinship as I am about the homology between cancer and capitalism that,
following Karatani, Cazdyn insists upon. I would agree that there is,
contrariwise, a good deal of evidence for the increasingly heteronormative character of state policies around the world, including those
that pertain to migration between states. Yet I would argue that the
homology between cancer and capitalism makes it impossible to think
the politics of mutation beyond the symbolic but inapplicable terms of
lack and plenitude, or beyond the positivist ranges of abnormal and
normal.
In a sense, The Already Dead is deeply ambivalent about how to characterize and periodize the terms of norm and crisis, even as it begins
with an exemplary psychoanalytic joke about the norm as the emergency (Cazdyn, 1). This could have raised the questionif crisis has
become normwhat, if any, sense is there in continuing to talk about
the abnormal? Indeed, Canguilhems The Normal and the Pathological
presented this very problem in the context of a discussion about the
eclipse of qualitative theories of disease (and therefore cure) by quantitative measures. According to Canguilhem, where pathology had once
been viewed as an ontologically distinct state from that of health, from
the 1800s illness became increasingly deWned as a measurable deviation
209
210
Book Reviews
211
212
Book Reviews
Works Cited
Canguilhem, Georges. 1989. The Normal and the Pathological. New York: Zone Books.
Cazdyn, Eric. 2012. The Already Dead: The New Time of Politics, Culture and Illness.
Durham: Duke University Press.
Keating, Peter, and Alberto Cambrosio. 2003. Biomedical Platforms: Realigning the
Normal and the Pathological in Late-Twentieth-Century Medicine. Cambridge, Mass.:
MIT Press.
Lacan, Jacques, and Jacques-Alain Miller. 1991. The Seminar, Book VIII: Transference
(In Its Subjective Disparity). Paris: Seuil. (Orig. pub. 196061.)
Lukcs, Gyrgy. 1971. History and Class Consciousness. Cambridge, Mass.: MIT Press.
Luxemburg, Rosa. 1989. Reform or Revolution. London: Bookmarks. (Orig. pub. 1900.)
Mattick, Paul. 1978. Anti-Bolshevik Communism. White Plains, N.Y.: M. E. Sharpe.
(Orig. pub. 1947.)
Mnoret, Marie. 1999. Les Temps Du Cancer. Paris: CNRS.
213