I started this post in May 2010, shortly after the event I termed Backpocalypse 2010 (in an ill-disguised attempt to use humor to distance myself from the pain and terror I felt), in which I injured my back to the point of needing to take a hiatus from my course of study at massage school. But while the personal resonance mentioned below has lessened some, the questions and issues involved are still here, and still concern me — and ought, I would argue, concern you.
Should we strive to be healthy? Most people would say yes.
Do we have an obligation — to ourselves, our families, our community (or country, or world for that matter) — to maximize our health; by which we are supposed to understand to mean our ability to function (to be “productive”, preferably in an explicitly capitalist way), and the longevity thereof? Maybe you wouldn’t say yes to this, but it’s the same question as above, just explicated a little.
I say no. Why?
As it stands, the moral obligation to be “healthy” according to the above definition is what:
- gives fatphobes the “right” to comment on my appearance, my diet, my activity level, my life (because, of course, everyone knows that fat is unhealthy).
- creates pressure on a pregnant person to use every test available to determine whether her pregnancy is “healthy enough” to continue, whether or not she herself wishes to.
- supports telling some people that they are not good enough to have children in the first place — because how dare they risk passing their disability, their atypicality, their ill health, their moral failing on to another generation?
- allows us to shame women for not breastfeeding, rather than focusing on the ways we can help her meet her own breastfeeding goals.
- defends forced-medication rulings for those whose thoughts and emotions don’t fit society’s expectations.
- allows us to tsk-tsk “those people” for not eating “right”, for making “bad food choices”, ignoring the multitude of reasons why people (especially those without class privilege) might eat “suboptimal” food.
None of that is OK.
The idea of moral obligation to heath has a particular resonance right now, when I feel the sting of inability, when I question my worth as I possibly fail, again, at a goal I have set myself.
Long ago I gave up on trying to fit into office work. Then I gave up (or set aside) the idea of being an academic student in a traditional college (which hurt far more than giving up temping, as you can imagine). Now I’m facing the potential loss of practicing massage therapy1, while simultaneously finding myself unable to eke out enough time to write, either. And I wonder: what is the point of me? Am I ever going to be able to make a living? If not, what good am I?
And the assumption behind those fears is, of course, highly problematic. It is the idea that we are only valuable for what we earn or produce — a capitalistic definition of “value”.
Which is not to say I “shouldn’t” want health or productivity for itself — nor that I should. Let’s just toss out all “shoulds”. The simple fact is that I DO want to do these things for themselves (I chose massage because I love it), and I DO want to be “productive” because I, like almost everyone else on the planet, want to be part of something (my community, my movement, my tribe, my family). The problem isn’t the idea of health2 or productivity; the problem is when we make those things moral obligations, rather than recognizing that they have inherent value, and that, lacking outside pressure, people will still want them for themselves.
When we make health an obligation, we create a hierarchy of people, based often on things outside of their own control. We say that some people are better than others, because of chance or choice or circumstance. We say that if you’re not “healthy” (by whatever criteria the judger has decided to focus on, often related barely or not at all to my or your or science’s definition of “health”), you aren’t working hard enough, you don’t know enough, you aren’t buying the right things. We allow people the grace of bad luck old chap if they can prove that it’s not their fault (and please, dear reader, take a moment to contemplate the impossibility of proving a negative, and the burden of having to do it over, and over, and over again), but still, under that, is the sometimes unspoken yet always detectable question are you really doing everything you possibly could to get better?
The burden this places on people — is placing on me — makes a difficult situation so very much worse (or, for some, turns what is simply and joyfully their life into a trial — not the state of their health but the social conversation around it is what drags them down). It’s not enough that we may not have the health we want, that our bodies may not do what we wish of them, that we may be limited in our choices: the moral obligation to health means we are failing those around us. It’s not enough that we may struggle, that I struggle: the moral obligation to health means we struggle with our society’s disapproval as well.
So no, I do not believe there is a moral obligation to health in some imaginary “objective” sense, nor that we as a society should impose one. Rather, I would say, society has the moral obligation to assist each person to be as healthy as ze wants to be (including, as my culture so spectacularly fails at right now, removing barriers to health and health care), and to respect the intrinsic motivation and decision making of its members.
Health — in the fullest sense of an individual’s optimal wellness, whatever that means to them — is not something we need to bribe or shame or obligate each other into pursuing. And to try is not only futile but counterproductive and often, as I feel so acutely now, cruel.
In the nearly-year since I started writing this, I have spent hundreds of hours in many practitioners’ offices working to regain my ability to move and to perform massage safely and without pain; have graduated massage school; and just this week passed the written portion of my licensing exam. The imposition of a “should”, an obligation, toward health added a layer of anxiety to my initial period of injury that this post reflects — but it was out of my own desire, not out of obligation, that I worked so hard toward recovery and that I continue to work on my physical wellness. It was only after coming to some sort of peace with the idea that I might not be able to perform massage — might not be productive in the way I’d so long planned, might once again fail, or defy, the expectations and pressures society places on me — that I was able to be centered enough to move forward, and do it in a way that was healthy for all of me, body and mind.