Last week I attended a workshop at Birkbeck called The Chronic: Temporality, Care and Health. It was organised by Dr. Shaul Bar-Haim and Dr. Gill Partington as part of the larger Waiting Times research project. In the blurb for the event they describe chronic time as:
complex and contradictory: For the sufferer it may entail states of on-going crisis and emergency, but simultaneously a stilled, arrested and even recursive time. There may be cycles of remission and relapse, uncertain prognosis, waiting for treatment, and simply waiting to see. ‘Time hangs heavy, yet there is so little of it’ as the dying cancer patient in Margaret Edson’s play, Wit, states. Chronic time may be simultaneously urgent and slow, both terminal and interminable.
I presented on a panel with Victoria Browne and Martin O'Brien where we suggested what the broader political implications of the chronic might be. I thought I'd share my own contribution, which links the chronic to environmental discourses that talk about climate health. Any feedback on these preliminary ideas would be very welcome.
Climate Change as Chronic Condition?
In thinking about this presentation, I wanted to try and get a better sense of what it was to live the time of a chronic condition. And so my partner graciously shared his experiences of having Type 1 Diabetes since he was 11 years old. He first talked about the rigidity of time when he was growing up. Having to eat and inject at the same times every day. But he also talked about the experience of being diagnosed itself. He said that in those first few hours of being told there was already a sense of things ending. Often when you are ill you are told how you are going to get better, you enter the temporality of recovery, which can also be very hard, but it has a different kind of arc to it, the diagnosis is a beginning of getting better and eventually getting back to normal. For my partner, though, the diagnosis of diabetes meant that there wasn’t this trajectory in front of him. He couldn’t reverse it, he couldn’t fix it, he couldn’t do anything about it. This was what he was going to be until he died. It even felt, at age 11, that he could already read the last page of his book. He knew he’d have diabetes when he died, he’d still be doing injections on his death bed.
So I was thinking what I might offer today about this sense of 'the chronic', what suggestion I might make about how it might travel in different ways or what it might offer to other domains. And what I want to suggest is that it might be helpful when thought in relation to climate change and environmental crisis.
Within environmental thought, the health metaphor has been a persistent one, even while it has also been strongly critiqued. There is the classic phrase from Rowe, for example, that “the Earth is running a fever, and we are the virus.” James Lovelock, in his work on the Gaia theory has talked about the need to develop a “planetary medicine”, while Aldo Leopard talked about "land health" and "land doctoring".
Critiques of the use of the metaphor include those of ecologists who argue that it is an “invalid analogy with human health requiring acceptance of an optimum condition and homeostatic processes” (Wicklum & Davies 1995). Basically it misunderstands how ecosystems work and idealises states of equilibrium. Even so, others within ecosystem services have persisted in talking about the health of ecosystems (eg Rappaport et al. 1998) and some environmental philosophers have argued that the metaphor focuses attention on the intrinsic values of environments since health is generally valued in and of itself (eg Callicott 1992).
But in all the talk of land doctoring and planetary medicine the kinds of conditions that are pressed into use as metaphor seem to be acute ones rather than chronic conditions. Fevers, viruses, parasitic infections, are all seemingly amenable to action. The aim is to cure, to recover, to repair. Of course some viruses and infections can be chronic, but from my initial look into the area, this is not how the problem is conceptualised.
Here I’m interested in how the time of recovery and the time of the chronic are linked to ideas of agency in different ways. As some of you will probably know, I’ve long been fascinated by anthropologist Carol Greenhouse’s contention that concepts of time can also be read as theories of agency. That is, our ideas of time carry with them assumptions about how change happens, what counts as a change and who can make changes. In the time of recovery for example, there is a sense of being able to transform the patient from the sick to the well. This is done in part by the knowledge of the doctor and the efforts of the patient. There is an arc of moving from pain and suffering towards health and recovery.
In many discussions around the health of the planet and ecosystem health, this sense of agency - of the possibility of recovery if there is the right diagnosis from the experts and the right efforts from everyone else - is dominant. Many are hoping that the condition is an acute one.
But what if the changes in the environmental are chronic rather than acute. What if, we receive a diagnosis which tells us that things can’t be reversed and can’t simply be fixed. What if we are facing a future where a significantly altered environment would be with us from now on and through the passing of many future generations. We’d never have an end to managing the condition, never be able to have a time when we 'went back to normal.'
Here I’m thinking, for example, of recent research on the West Antarctic ice shelves, which suggests that we are now locked into a 1.2 meter sea level rise. The warmer sea waters are cutting up under the ice and quickly advancing back up on land because the land the ice is resting on is below sea level. This is thought to be a process that now cannot be reversed.
So, I suppose what I want to suggest is that developing thinking around the way chronic time works and how it is experienced seems to me at least to, potentially, be incredibly useful for understanding the relationships between time, agency and environmental change. It might, for example, encourage us to see the significance of what is going on in very different terms and to adopt a different set of coping mechanisms.