Zygmunt Bauman, who sadly passed away at the age of 91 in January, was one of the most influential sociologists of his generation. Bauman was Professor of Sociology at the University of Leeds from 1972 until his retirement in 1990. A prolific writer, he published over 50 books over his lifetime, on topics ranging from the Holocaust to globalization and consumerism, developing the now famous notion of Liquid Modernity to capture the consequences of dissolving institutions and social arrangements for individuals’ sense of self and belonging. Drawing from his own experiences of fleeing Poland with his Jewish family, once from the Nazis and then again from the Communists, he was particularly focused upon inequality and its consequences for the poor and dispossessed. It is hard to capture the sheer weight of his contribution, although there have been many thoughtful and moving tributes from colleagues and admirers over recent months.
Bauman’s focus on the powerful contradictions and ambivalence at the heart of the postmodern project is especially relevant to contemporary practices of health. Nowadays, there are few overtly eugenic programmes of mass sterilization or incarceration, but as Bauman demonstrates, many more subtle and privatized ways of eliminating or assimilating the ‘neither-nors’, strangers and others who do not ‘fit’ with the social order. These processes are, of course, not confined to public health or other kinds of medical initiatives, replete as they are in many aspects of social life, from housing to social care to immigration and welfare policies. Yet they do have a particular relevance to reproductive and other health screening programmes designed to identify and rectify bodily deviancies of various sorts. Thinking, for example, about how prospective parents or genetically ‘at risk’ individuals negotiate their responsibilities for their or their children’s health, Bauman’s caution about the lure of individual choice as a policy or personal solution to these complexities is particularly apt. His focus on how such choices always have to be ‘confirmed and validated’ also captures the subtle social processes through which choices are guided to particular conclusions, and the limits this places on individual freedoms and flourishing.
Bauman’s Mortality, Immortality and Other Life Strategies (1992) also offers important insights into how struggle for health and social recognition are entwined with deeper struggles around the meaning of life, and death, not only in terms of individuals’ own sense of self but in terms of how social institutions are organised and perpetuated. Here Bauman reminds us that the avoidance of death is fundamental to the organization of human culture, conceptualizing culture itself as a device for suppressing our knowledge of death: ‘The first activity of culture relates to survival – pushing back the moment of death, extending the life-span’. For Bauman, nationhood, wealth creation, kinship, history, art, scholarship, religion and notoriety in the ‘mediocractic age’ are all various ‘bids for immortality’. This frames his deeper engagement with cultures of health and immortality, again focused around two main contrasting approaches of modernity and postmodernity.
Bauman describes the modern approach to ‘deconstructing mortality’, explaining our past and ongoing obsessions with trying to ‘redefine the unmanageable problem of death’ as ‘a series of utterly manageable problems’ of health and fitness. Here death becomes another illness, and ‘existential worry can now be all but forgotten in the daily bustle about health’. But ‘the price for exchanging immortality for health is life lived in the shadow of death; to postpone death, one needs to surrender life to fighting it’. He compares this with a second postmodern strategy which takes a different approach, dazzling us with high tech solutions and reassuring us that medicine will provide a cure through the next set of test results and data-driven medical interventions. Bauman sees these approaches as particularly costly in the sense that they will only be available to the wealthy few, and because they pitch us all into a ‘perpetual game of chance’ as we navigate the certainties and inevitable uncertainties each test result delivers.
In these two contrasting sketches of our struggles over health Bauman captures the complexities of contemporary and future approaches to treatment of diseases like cancer in the genomics era. His description helps us to understand how patients, families and practitioners are at once involved in managing the business of terminal cancer as a series of problems of health to be managed, whilst also being increasingly drawn into experimental treatments and monitoring which promise more personalized, targeted treatments and solutions. He also gives us a keen sense of the difficulties of navigating these various approaches to health and disease. His writing helps to explain the huge amounts of time and energy that participants can end up giving to these treatments, trials and projects of the self – a recent example of this can be found in Steve Hewlett’s cancer diaries. It also gives us insights into the rollercoaster ride of managing short-term successes which can turn into failures and untimely death despite the best efforts of all involved. For me this is where Bauman excels as a writer and a thinker – he grasps and beautifully articulates the tangle of hope, pain and suffering at the heart of the struggle for health and the human condition, always linking these private troubles to wider political and economic shifts in the nature of society.
In a later volume Moral Blindness: The Loss of Sensitivity in Liquid Modernity (2013), written together with Leonidas Donskis, Bauman returns to this theme of suffering once more, focusing on the cultures of consumption in which these struggles for health and belonging are played out. Ever-attuned to the kinds of suffering individuals experience as a result of atomisation and precarity, Bauman reminds us once again of the costs of consumer societies for wellbeing: ‘The more consistently I deploy the collectively suggested or enforced strategy of survival, the more alone I am left’. This delves still deeper into the kinds of struggles for health of people experiencing disease, disability, depression and other mental health conditions, pointing out the profound ambivalence of consumerism with heartbreaking clarity. In trying to conform, to be good healthy citizens, we seek social validation and belonging, but we suffer feelings of isolation and loneliness as a consequence of these struggles when this longed for validation is only ever fleetingly experienced. Here Bauman reminds us once again of the need for sensitivity as social actors, scholars and practitioners and the importance of humbler kinds of solidarity and everyday empathy in the quest for health.
Zygmunt Bauman, sociologist, born 19 November 1925; died 9 January 2017
About the Author: Anne Kerr is Professor of Sociology at the University of Leeds, with a special focus on science and medicine. Anne currently holds a joint Wellcome Trust Senior Investigator Award in Society and Ethics (with Sarah Cunningham-Burley, Edinburgh), researching how cancer patienthood is changing in the era of genomic medicine. She has researched and written on genetics, assisted conception, biomedical innovation, gender and science, particularly with respect to professional ethics and lay expertise.