What the Body Needs
Technology has torn through all that’s worth conserving, and it has often preferred to wear a white coat while doing so. Yet medicine and health cannot escape the human body in all its glory, frailty, and limits, and it is out from that center of moral gravity that we can build. Strictly defining medicine’s rightful authority, embracing the limits of embodiment, and building communities where we suffer together and embrace those who are suffering even to our own hurt gives us the framework we need for technology that serves human nature rather than destroys it.
For a tech-skeptic lover of Wendell Berry, Ivan Illich, and Neil Postman, as a family physician I sure picked the wrong job. Doctors have always used various technologies for treating patients, from the ancient Egyptian prescription to fumigate the womb with incense for eye pain to today’s slightly more informed but still ineffective placebo surgeries. The human body as it has been given to us by God has all sorts of vulnerabilities — to infection, to trauma, to its processes gone awry — and technology gives us power to prevent or treat a wide variety of problems that arise from those vulnerabilities.
To make matters worse, though, nowadays doctors have admitted that they cannot know everything and so they have abandoned their pocket handbooks for databases on smartphones. A good doctor, I tell my students, looks up something new every day and books cannot be printed quickly enough to keep us all up to date. My use of WhatsApp to examine rashes or read ECGs is a bit more primitive than the systems that are evolving in highly developed contexts, but medical practitioners everywhere are finding that technology is invading every imaginable aspect of their work.
This might be tolerable if it was all beneficial, but it’s clearly not. Francis Bacon famously urged us to use science and technology to ameliorate human suffering, but now the Baconian Project has fooled us moderns into thinking that suffering ought to be optional, and we must use technology to eliminate suffering. If technology gives us the power to turn stem cells into useful organs, turn useful organs into simulacra of the opposite sex’s organs, or eliminate un-useful children before they are born, the logic of technology is that those powers ought to be used. If technology doesn’t work, as it often doesn’t, Stanley Hauerwas has suggested that doctors who are unable to ameliorate suffering effectively often feel the need to kill the sufferer.
One can find countless examples of Jon Askonas’ thesis that technological innovation bulldozes tradition throughout medicine; a new drug or device can make years of careful study and practice unnecessary. For the most part, this is a good thing: the vexatiously difficult-to-dose blood thinner warfarin was replaced by much simpler drugs about a decade ago, requiring far less expertise and work from the doctors prescribing it. Yet the existence of any new drug, device, or treatment tends to inspire a search for patients with insurance who will pay for them. Disease mongering, indication creep, overuse of fancy gadgets, and the marketing of insecurity to sell cosmetic surgery have been problems for decades, now reaching a horrifying apotheosis in the current craze of teenagers being memed into thinking that they should be chemically or surgically altered to change their gender expression.
More subtle are phenomena like antibiotics, which are one of modern medicine’s greatest gifts and thus have been terribly abused to the point where now it is an open question whether we will have any working antibiotics in fifty years. The culture that the technology of antibiotics created — desiring a pill or injection to immediately cure an infection — has made antibiotics less effective. Whenever one tries to assert the dangers of technology to human culture and flourishing, antibiotics are one of the first examples that uncritical devotees to the Baconian Project point to: So, you conservatives want to take us back to when we didn’t have penicillin? No, in fact, the revolutionary way in which we have been shaped by technology is already taking us back to the pre-antibiotic era.