The Plastic Health Crisis

24 September 2021

by Sinéad Murphy

On September 20th, the U.K. Government began its programme of Covid vaccination in schools, having approved the experimental mRNA injections for healthy children between the ages of 12 and 15.

Just over two weeks earlier, the Government’s advisory committee on vaccination and immunisation – the JCVI – announced that they could not, on health grounds, recommend these injections for 12 to 15 year-olds; the margins of benefit were simply too small, they said.

One week after that, the Government’s Chief Medical Advisor, Professor Chris Whitty, trumped the advice of the JCVI, recommending the Covid vaccinations for 12-15 year-olds after all. His word carried the day, and the programme that he sanctioned is now in train.

But on what grounds did Chris Whitty approve the Covid vaccines for children, given that the JCVI declined to approve them on health grounds? He approved them… on health grounds. Offering the vaccines to children of 12 to 15 years would assuage their fear of the virus and help them to feel that the Covid crisis is coming to an end, he claimed, and would therefore be a significant benefit for what he termed their “mental health”.

Such is the wily ascendancy of the concept of ‘health’ that having refused the vaccination of children on health grounds it then granted the vaccination of children on health grounds.

* * *

In his book Plastic Words, Uwe Pörksen described how certain concepts come to acquire infinite flexibility and dominance, enveloping our powers of describing and understanding in their apparently profound ubiquity.

Plastic words are not technical words, Pörksen advised, which are often strictly limited to contexts and therefore of more or less restricted relevance. Plastic words are ordinary words, which have been taken from common parlance, refracted through one or other field of science, and returned to everyday talk with a new, broadened application and a new, somewhat ambiguous, authority.

Examples of plastic words are: “development”, “progress” and “communication”. Banal terms plucked from their historical parameters of use and conferred with a quasi-technicality that is not the less effective for being vague and accommodating.

Unlike jargon words, we can and do use plastic words freely and easily, Pörksen argues. We say that “progress in strategies of communication supports social development”, or that “development of communication styles is linked to progress”. In so saying, we have said very little – these statements do not mean anything, really. But we have also said very much, tapping into a seam of apparently scientific understanding that is sophisticated and worthy of being considered. We have given our talk a modern aura, and availed ourselves simultaneously of the unobjectionableness of common sense and the force of expertise.

Plastic words denote nothing, as Pörksen expresses it – the statement “progress in communication aids development” is nonsense. But plastic words are richly connotative. So much so that they suck the life from more specific, more nuanced, vernacular words, which are overshadowed by the apparent sophistication of plastic words and gradually fall out of favour.

There is an underbelly to using plastic words, however. The air of modern sophistication with which they infuse our descriptions is a thin one. Having revelled in its effect, we are bereft of any real appreciation of the stakes in whatever it is we have used them to describe, and must rely on professional analysis and advice for any substantial judgment. Using plastic words remakes us into clients of experts, Pörksen observes.

For this reason, the more we have recourse to plastic words, the less we are able to accurately describe and understand ourselves, each other and the world around us. Until at last we are at the mercy of expert analysis and advice, even for understanding events and negotiating situations that are quite concrete and personal.

* * *

In this context, it is worth considering what it might be like to use language that is not overshadowed by plastic words.

For this, two letters written by Jane Austen will do very well. They were sent to her sister Cassandra in the penultimate week of the year 1798, when the author was twenty-three and her sister two years older and the latter was staying with their brother Edward for the holiday season.

The first of these letters includes the following:

My Mother continues hearty, her appetite and nights are very good, but her Bowels are still not entirely settled, and she sometimes complains of an Asthma, a Dropsy, Water in her Chest and a Liver Disorder. The third Miss Irish Lefroy is going to be married to a Mr. Courtenay, but whether James or Charles I do not know… (December 1978.)

The second letter includes this:

Poor Edward! It is very hard that he who has everything else in the World that he can wish for, should not have good health too. – But I hope with the assistance of Bowel complaints, Faintnesses and Sicknesses, he will soon be restored to that Blessing likewise. – If his nervous complaint proceeded from a suppression of something that ought to be thrown out, which does not seem unlikely, the first of those Disorders may really be a remedy, and I sincerely wish it may, for I know no one more deserving of happiness without alloy than Edward is. – My Mother’s spirits are not affected by her complication of disorders; on the contrary they are altogether as good as ever; nor are you to suppose that these maladies are often thought of. – She has at times a tendency towards another which always relieves her, and that is, a gouty swelling and sensation about the ancles. – I cannot determine what to do about my new Gown; I wish such things were to be bought ready made…

One striking aspect of these short excerpts is the degree of involvement that they reveal, of two young women in the health concerns of their family members. Jane and her sister might well be expected to be too vibrant themselves to have much care for the low-level aliments of their parent and sibling. But not only are they exercised by these ailments, they trade in the most intimate and specific details about them: even their relations’ bowel movements are discussed, quite unhesitatingly and with interest.

Yet, this is no obsessiveness with matters of health. Jane trips lightly from the water in her mother’s chest to the romantic fortunes of a young neighbour and from the swelling in her mother’s ankles to the question of a new gown. Evidently, details of the condition of bodies and minds are common fare in the sisters’ conversations, woven seamlessly with other strands of daily interest.

Most striking of all in these excerpts, however, is the range of words that they have recourse to: “Dropsy,” “a gouty swelling and sensation”, “Liver Disorder”, “Water in the Chest”, “Faintnesses”, “settled Bowels”, “nervous complaint”, “something that ought to be thrown out”.  The sisters are well versed in the lexicon of maladies and remedies, their talk of such matters honed through constant practice.

The word “health” does make an appearance in these excepts – Edward’s “good health” is hoped for. But the word does not dominate, it does not have a special status, it does not overshadow the lively evocativeness of something being “thrown out” or of the “gouty swelling”. For it has yet to be transformed into a plastic word which grants its user the air of being very well-informed and up-to-date but also robs him of Austen-like powers of description and intervention, implicitly rendering him as subject to health institutions and their professionals.

The Invisible Committee, in their book The Coming Insurrection, wrote of the tendency of modern societies to stifle whatever it is that circulates between ourselves so that we are made helpless in negotiating the most basic components of our lives and must rely upon the expertise that is offered to us by institutions – of education, law, care, health, and so on.

A large part of this effect is produced by the roll-out of plastic words, which redirect even the most common pathways for the circulation of all that matters to us in our lives so that they pass through the official channels.

Jane Austen died at the age of 42. While there is dispute as to the cause of her death, it is most commonly attributed to Addison’s Disease. In our time, those who suffer from this disease are expected to enjoy a normal life span. Few would deny that this represents real medical progress, and that institutional expertise often produces admirable results.

However, the pursuit of medical progress and the circulation of health matters between ourselves are not mutually exclusive. Indeed, they ought to be complimentary. The problem, then, is not that experts and the institutions that support them exist and are at work, but that the kind of care for health that can only be undertaken as a low hum of daily describing and reporting and diagnosing and treating has been smothered by the seeming sophistication of plastic-word describing and reporting and diagnosing and treating, and we are reduced to relying on experts when we ought to take care of ourselves.

Perhaps no aspect of our lives has suffered from this smothering of our ability to look after ourselves as what is now summarised as ‘mental health’. Old people’s tears of loneliness – including on account of their Covid self-isolation; young people’s slump of disaffection –  including on account of their Covid estrangement from friends; parents’ palpitations of anxiety – including on account of their Covid confinement to home; students’ demotivation – including on account of the Covid cancellation of exams: all, and so much more, described as problems of ‘mental health’ and thereby at once robbed of their real significance and submitted to blanket solutions determined upon by professionals.

Care for our own and one another’s bodies and minds should circulate between us as easily as it circulated between Jane and Cassandra Austen, as easily as gossip about love and musings about gowns. But its circulation has largely been suspended by the creep to ubiquity of the concept of ‘health’, which has destroyed our confidence to look after ourselves and one another. So much so that when it comes to caring for our own children, we are deprived of proper faith in their native vigour and immunity and submit them to an ongoing medical trial whose medium- and long-term effects are unknown and whose short-term effects are already established as worrying.

Lost for words to describe and therefore understand the welfare of our children, we appeal to Chris Whitty to know what is best for them.

* * *

The most sinister moment in Pörksen’s account of the rise of plastic words is his claim that they displace, not only more nuanced, vernacular words, but also the silence that used to surround them. There is nowhere, Pörksen argues, that ‘progress’ is not important, no corner in which ‘development’ is not desirable, no instant when ‘communication’ does not occur.

Our concept of ‘health’ is fulfilling Pörksen’s grim prediction, inserting itself as a stake in the most out-of-the-way corners of our lives. We speak of “emotional health”, of “financial health”, of “relationship health”, of “personal health”, of “social health”, of “healthy eating”, a “healthy planet” and “healthy lifestyles”. There is no nook in which ‘health’ is not a possibility, no cranny in which expert advice must not be sought.

Jane Austen could leave her talk of health matters as easily as she could take them. She could dither blithely about her new gown and report breezily on her neighbour’s romance. But in our Covid era, there is no domain in which health is not at stake. Even gowns, even romance, fall under its sober shadow, as we browse in shops with sanitized hands and masked faces, and flick past the vaccination status of love prospects on Tinder.

Now, there is talk of ‘health’ everywhere and everywhere is a ‘health centre’: surgical masks handed out at the doors of churches; sanitized hands waved to the music at rock concerts; and experimental medicines administered in the classrooms of schools.

Dr. Sinead Murphy is an Associate Researcher in Philosophy at Newcastle University.