Chapter III: The Attack on Medicine

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The doctor, looking grave and solemn, began his examination. He took the patient's pulse rate and body temperature, and proceeded to the percussion and auscultation. With a certainty that left no room for doubt, Ivan Ilyich knew that all this was rubbish and fraud. (26) Leo Tolstoy

Ivan Illich. (27) The hero of this story is the near namesake of Tolstoy's Ivan Ilyich, professor Ivan Illich of Cuernavaca, Mexico. Illich, the Vienna-born quadruple graduate of European universities, and one time parish priest ministering to Manhattan's poor, has become the theorist and ardent advocate of rebellion against Western industrialized civilization. The grave moral failures of our civilization certainly have fed this movement, but some of its ideas can be traced to earlier sources, to the anarchism of Proudhon and Kropotkin, early 19.h century's romanticism, the views of J. J. Rousseau, and to the even earlier myth of the Happy Savage. Illich's anti-industrialism writings often surprise by their vehemence, uncompromising thoroughness, and unexpected targets of assault.

In Illich's view, the expanding technology very soon reaches the point beyond which it inevitably turns against people.

In the 1970s, Illich was widely acclaimed in the intellectual and professional circles of Western Europe and North America as the prophet who told us the truth about ourselves. Illich's teachings on the sinister activities of the medical Mafia not only supplied arguments for the Western European and, in particular, Holland's anti-medical campaign of the 1970s and 1980s, but, surprisingly, met with an enthusiastic response from many doctors. At the assembly of the British Medical Association in Edinburgh, Illich was given a standing ovation. Prominent physicians declared that when they read Illich's works, scales fell from their eyes. Apparently, the disappointment of "modern" physicians with their role, and with medicine in general, made them receptive to Illich's ideas. His name may now be almost forgotten, but this man has substantially contributed to the present crisis of medicine.

Several features of Illich's writings contributed to the powerful impact these publications had at the time. Their subject matter was of vital importance: it was the heaW price mankind was paying for industrialization, man's entanglement in the complexities of societal structure, the abysmal contrast between the First and the Third World. Illich's onslaught on institutions people had considered friendly (e.g., formal educational institutions), attested to the originality of the author's thought and his intellectual courage. The solution he proposed--no less than a total destruction of our civilization--showed Illich as a thorough thinker who wouldn't content himself with half-measures.

Yet Illich's success among intellectuals of the 1970s is an astonishing story. His allegations were, to put it mildly, biased and unreasonable, and his propositions radical and absurd. In his view, the school, for instance, was not a teaching institution with some faults and negative aspects; it was a criminal conspiracy to create social inequalities, and nothing else. This is patently untrue. It is also worth pointing out that without formal education nobody would be able to raise or debate the issues of Illich's writings. Neither could prof. Illich's favorite bike be designed or produced by uneducated workers. The village blacksmith wouldn't be able to make the lightweight metal frame, the precision bearing or the rubber tires, all of which require formal education in the sciences and engineering principles.

In Illich's view, the only aim of professional groups is power, and enslavement of other people .... Medicine is the area of Illich's particular interest. The doctors, he asserts, do not provide any useful services, but only seek to enhance their own wealth and power over the people. This is not true. Any man who once experienced the excruciating pain and pressure of urinary retention, and the wonderful relief provided by inserting a catheter, will refute Illich's absurd statement. …