Illness, mental and physical

Frontispiece of “The English Dance of Death.” Rowlandson, Thomas

Determining the origin of health, suffering, and pain as concepts may be futile, but death is prehistoric. Whether we have always thought that that we died of this or that is a different question. The causal logic of disease is not necessarily a universal given.

Key old texts reference disease, whether it’s Revelations 6:8, the Chester Beatty Medical Papyrus, or Babylonian pathology Even the epic of Gilgamesh: “Fate, destiny in its evil aspect; pictured as a demon of the underworld, also a messenger and chief minister of Ereshkigal; a bringer of disease and pestilence.” What currently holds and eludes my attention is the Western division of health by way of the body/mind distinction.

And I looked, and behold a pale horse: and his name that sat on him was Death, and Hell followed with him. And power was given unto them over the fourth part of the earth, to kill with sword, and with hunger, and with death, and with the beasts of the earth.

Revelations 6:8; KJV.

Throughout literature on death and disease there is slippage between the mind and body. In this respect I have to acknowledge the Foucault-inspired insight that our current discursive frame, or, the language and way that we think in the present informs how we read and think about the past. More plainly, it might be the case that there is slippage between language that mixes up the mind or body only because I am putting it there.

It remains that in our present time we are not very careful when we distinguish between “mental” illness and illness as such. The reason for this isn’t always nefarious: we still work to understand the ways in which what seems like a “mental” condition is found in the body, or the ways our mind makes symptoms and diseases manifest in our body. A classic example is the joke about the patient who sees a doctor about an arm pain they have. “Doctor, it hurts every time I move my pinky like this. What do I do?” The patient grabs hold of their pinky and pulls it back. The doctor makes some notes and responds, “Don’t move your pinky like that any more!”

The distinction between mental and physical health is yet a real one in contemporary life, and separating the two is an ill-fated venture. How could working 12-hour shifts for seven days a week not take an interrelated mental and physical toll on someone, for example? What does cure look like in this scenario? Time off work, a stimulant to keep awake, a more supportive social sphere, or surgery to keep the worker’s body healthy and able to work dramatic shifts?

The more sinister and real concerns that drive these thoughts regard the invocation of mental health when mass shootings occur. A cursory examination of the use of “health” in Western history has been invoked in the name of the domination of women (who are unhealthy and weaker by nature), eugenics (to weed out the disabled and sick), and racism (to manage and exploit naturally inferior races). Who is deemed deserving of mental health, affection, and attention? When mental health is invoked as a response to mass shootings, who will actually be deemed mentally ill and deprived of the right to own guns, and who will be deemed worthy of robust social attention and care? How distinct will this be from the access to “physical” health?