Recently, I taught my first upper-level course on the history of health and medicine in the United States. The course readings covered a broad base, both chronologically and thematically. The discussions that emerged from two of the assigned texts, however, really stand out in my memory.
“Frequently employed in both slave sales and medical jurisprudence, the term indicated an enslaved person’s overall state of health and, by extension, his or her worth in the marketplace….Soundness in its most basic sense concerned the health of a slave, measured in his or her capacity to labor, at the time of sale. Yet the definition of soundness included not only the present health of the individual but past and future health as well….Not limited to the physical body, the concept of soundness extended to mental and moral dimensions of slave health as well.” (Sharla M. Fett, Working Cures: Healing, Health, and Power on Southern Slave Plantations, p. 20)
“Neurasthenia was the characteristic illness of its day. The name derives from Greek and translates roughly to ‘lack of nerve energy.’…The illness typically struck urbanites, especially those men and women carrying on busy lives stretched thin by responsibilities to their families, communities, and jobs….The neurasthenia diagnosis provided an elastic, protean concept of sickness that allowed Americans to better understand and speak about the nature of their mental and physical ailments.” (David G. Schuster, Neurasthenic Nation: America’s Search for Health, Happiness, and Comfort, 1869-1920, p. 2-3)
In retrospect, I can see that these two texts in particular shaped the emergence of an unexpected theme in the course: a critique of both the concept and rhetoric of wellness that is so prevalent in contemporary American workplaces, including many college campuses. The McKinley Health Center at the University of Illinois at Urbana-Champaign defines wellness as “a state of optimal well-being that is oriented toward maximizing an individual’s potential. This is a life-long process of moving towards enhancing your physical, intellectual, emotional, social, spiritual, and environmental well-being.”
As the quotes extracted above highlight, there has long been an interest in safeguarding what we might call a more holistic view of health, one that encompasses the emotional and spiritual as well as the physical and cognitive. Historically, as Sharla Fett and David Schuster have demonstrated in their books, this concern with an individual’s health has not been the result of an interest in basic human rights and dignity or a cultural commitment to enriching the quality of one’s life. Much the opposite, this holistic view of individual health has been intent upon the maintenance of a productive labor force, whether we’re talking about enslaved people working on southern plantations or white middle class men dealing with the pressures of modern white collar wage labor. The experiences of these two groups could not have been more different, and comparing them was not the point of this post or my students’ discussion. Yet, in both cases, the medical establishment crafted definitions of health and disease centered on their ability to labor effectively. To be unsound or neurasthenic meant that you were somehow incapable of performing the role expected of you. There would be an examination, a diagnosis, and a treatment to restore your body or mind. Your recovery would be celebrated when you returned to work, whether in the cotton field or the managerial office (or stuck in the home, if you were a white woman, but that’s another issue, best demonstrated in Charlotte Perkins Gilman’s short story, The Yellow Wallpaper). In short, in all of these cases, there was a clear correlation between health and productivity, one that reduced the individual to a body that was either productive or unproductive. And there was a great deal of anxiety about how to create the best environment and best conditions for those bodies to remain healthy and productive.
I’m not sure when it was exactly that my class first made a connection between our discussion of the-productive-body-as-healthy-body and the events promoting wellness on our campus. But at some point this language of wellness became shorthand of sorts as we discussed first Working Cures and then Neurasthenic Nation. Even as we recognized the immense differences between both of those subjects in relation to one another as well as in relation to our own situations, we also found the similarities in the rhetoric to be striking. Something about it irked us. Were we, too, just another generation of cogs in the capitalist machine?
These conversations with my students altered how I thought about wellness. In some sense, wellness already had become one more thing that I had to do. They say that wellness helps you reach your potential. Wellness makes you happier. And thinner. And more pleasant to be around. If I didn’t actively pursue wellness, then I was letting down my work community and my family. I had to make time for wellness so that the time I spent doing other things, like teaching and writing and grading and editing, would be more…productive. I started thinking that perhaps the pursuit of wellness wasn’t really in my best interest after all.
Don’t get me wrong: I’m not against wellness. I am very, very grateful that my campus puts a great deal of resources into promoting the physical, mental, emotional, and spiritual well-being of faculty, staff, and students. I appreciate being part of a community in which we encourage each other to thrive and succeed in all sorts of ways. I wish more employers in academia and beyond were so intentional in this practice. But I think my students were on to something. When the rhetoric of wellness becomes infused with that of productivity, such as when the justification for providing your workers with wellness benefits and resources revolves around improving their workplace performance or reducing health costs for employer-sponsored plans, or when magazines offer us checklists of things to do to improve our work day, such as taking a power nap or doing yoga at our desks, then I think we are on a slippery slope. Like the men and women enslaved on the plantations of the past, we would do well to remember that a truly holistic view of health is not one that measures individual output or what we contribute materially to our society. Instead, we should attend to physical, emotional, cognitive, and spiritual wellness simply because each individual matters. Period. Elizabeth Cady Stanton called this “the solitude of the self:”
“There is a solitude which each and every one of us has always carried with him, more inaccessible than the ice-cold mountains, more profound than the midnight sea; the solitude of self. Our inner being which we call ourself, no eye nor touch of man or angel has ever pierced. It is more hidden than the caves of the gnome; the sacred adytum of the oracle; the hidden chamber of Eleusinian mystery, for to it only omniscience is permitted to enter. Such is individual life.”
Wellness, it seems to me, should be about nurturing this individual sense of self. It should not be about what we can give or produce, but simply about recognizing who we are. I am so happy that my students taught me this lesson.
I doubt that your students taught you anything. It is clear to me that you apply your point of view on current society (your unacceptance of capitalism) to teaching your students and yourself of digging nuances of words. Today’s talk about slavery serves only one purpose: division of people. From this post I made a conclusion that you are: a feminist, a political activist and a Democrat. Am I right?
Am I also right that you answered my comment but you did not publish it on your post?
Is not is cowardly?
She is looking to take over the world. I would run if were you JF.
It’s too bad JF thinks the terms feminist, political activist, and Democrat are slurs. I consider them a source of pride. Oh and JF forgot to add that Carolyn is an intellectual badass.
JF, while I am happy you are so engaged in this story, as the Executive Editor of Nursing Clio, I would like to direct you to our commenting policy which states:
“While we at Nursing Clio value the free exchange of ideas and opinions, we reserve the right to edit and/or delete any comments of an abusive, absurd, irrelevant, or nonsensical nature. We require that posted comments meet our standard for civil discourse. As in the salons of previous centuries, boorish behavior will not be excused.”
Please refrain from name calling or accusations or you run the risk of having your comments not published. Please see our disclaimer page for a fuller discussion of Nursing Clio’s policies. We are all free to disagree and debate, but we must do it politely.
Dear Anne, I agree with you that Carolyn is an intellectual badass.
I don’t think that political activist or a Democrat are slurs.
However, I believe that professors have no right to influence their students political views using any possible means.
As regarding the term “feminist”, I believe that today feminism became a reactionary movement in the USA. Where were all feminists when two American universities publicly insulted two extraordinary black women known to the whole world?
I appreciate the strong response my post has provoked. I’m glad that you found it interesting and worthy of response. However, your comments are becoming attacks on my character, my views, and my teaching methods — all of which are none of your business. I’m happy to hear your ideas about the meaning of wellness and how it connects to other ideas in our society, including notions of productivity, but I will not be responding to and we will not be approving any further comments that reference me personally.
Very thought-provoking post, Carolyn! For an alternative conception of wellness as community health, check out Jennifer Nelson, “Healthcare Reconsidered: Forging Community Wellness in the South,” http://muse.jhu.edu/login?auth=0&type=summary&url=/journals/bulletin_of_the_history_of_medicine/v081/81.3nelson.html
Thanks, Beatrix! I will look for that. Also, just fyi, I assigned your book in the class, too. The students really liked it.
Dear Cheryl, during my life in the USSR I met different people (including members of KGB).
I am not scared of people anymore. But I am surprised that seemingly intelligent people can do everything to destroy their country and, as a final result, their very comfortable lifestyles.
Great post! This reminds me of a discussion we had in my Gender & Disability seminar this spring about Kim Nielsen’s A Disability History of the United States. We talked about how disability has historically been defined as the inability to work productively in post-industrial societies.
Cara, this is a great point. Jim Downs also has a wonderful discussion of the relationship between productivity, labor, disability, and gender in his book, Sick from Freedom: African-American Illness and Suffering during the Civil War and Reconstruction.
Where is the ‘like’ button? 🙂
Great post, Carolyn! I’m gonna use it in my class next spring on Women’s Health Narratives in American Culture. It really does an excellent job tying together some seemingly divergent threads of medical and health rhetoric.
I really enjoyed this post, especially as I’m someone who once bought a book called “Relaxation for Dummies.”
Monica, that is too funny. I might look for a copy for myself…
Reblogged this on DailyHistory.org and commented:
On Nursing Clio, Carolyn Herbst Lewis probes the connections between ideas about wellness and ideas about productivity. Are we, she asks, “another generation of cogs in the capitalist machine?”
“Like the men and women enslaved on the plantations of the past, we would do well to remember that a truly holistic view of health is not one that measures individual output or what we contribute materially to our society. Instead, we should attend to physical, emotional, cognitive, and spiritual wellness simply because each individual matters.”
You should read Fett’s book. It’s really incredible to think about beliefs about “health” as resistance. Great read.
I think you’re right that capitalism encourages health toward the end of productivity; we see this also with the rehabilitation of disabled soldiers after World War I. The World Health Organization’s 1949 Constitution is often cited as a source for total-wellness statements like the U of I’s (my home campus): “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” That must have been a forward-looking statement when it was written and probably does not reflect wide-spread common beliefs at the time but rather was written in response to the eugenics programs across Europe and North America that directed individual health toward collective ends (“the health of the nation/people’s community”).
WHO Constitution: http://apps.who.int/gb/bd/PDF/bd47/EN/constitution-en.pdf
Thanks for your comment and the WHO source. Just seeing it now, for some reason.