The Medical Committee for Human Rights: A Case Study in the Self-Liquidation of the New Left (part 2)

Kotelchuk, Rhonda, and Levy, Howard (1986). The Medical Committee for Human Rights: A Case Study in the Self-Liquidation of the New Left. In Race, Politics, and Culture: Critical Essays on the Radicalism of the 1960s. Reed, Adolph, ed. New York, Greenwood Press.

Counterculture and Free Clinics As the New Authenticity

Although a bit more complicated than the antiwar movement, the role played by the MCHR in the second great activity of the late 1960s---the counterculture movement---was fundamentally similar. The year 1967 marked the birth of the Haight-Ashbury Free Clinic, the flower child, and the long-haired hippie. The counterculture proved to have a magnetic attraction to young health workers and students.¹

Indeed the counterculture suggested a way out to health-science students, interns, residents, nurses, and technical personnel who felt oppressed by years of grueling study, regimentation, pleasure denial, and hierarchically ordered health institutions. These young professionals had come to understand that health-science education involved more than learning about disease diagnosis, treatment, and (least of all) prevention, but rather involved a total socializing process. Doctors and nurses were being taught to accept their class and professional roles, along with the attendant alienation.

If medical and nursing school and hospital medical practice seemed to embody the objectivization of young professionals, then the recovery of subjectivity that free clinics and the counterculture seemed to offer came as a godsend to many. They represented a strong antidote to the treatment of students as computer punch cards. (The "do not bend, fold or mutilate" mentality of college deans pertained no less to health-science school officials and hospital administrators.) In free clinics young professionals saw the promise of rebellion, a new lifestyle, immediate fulfullment, and an overcoming of the personal alienation, ego disintegration, and humiliation that had been their daily bread for all of their lives. Free clinics seemed to offer not merely a vision of the future but a utopia in the here and now. Moreover, so it was claimed, by the sheer weight of their example they would undermine the values of the health system.

While few local MCHR chapters actually set up their own free clinics, almost all chapters had members whose major energies were expended working in them. Some were attracted to this work by the "good vibes" of the counterculture, but many more politically sophisticated MCHR members rejected as fatuous the political claims made in support of free clinics. Indeed, for many MCHR members the attention paid to the middle-class, white hippie clientele of the earliest free clinics represented a self-indulgent waste and sellout of the needs of the most oppressed members of American society.

Free clinics, however, were not long to remain the preserve of the counterculture. Minus some of their countercultural accoutrements, free clinics fit perfectly into the community-organizing strategies of the Black Panthers, I Wor Kuen (a revolutionary group in New York City's Chinatown) and various revolutionary Chicano, Puerto Rican and immigrant white Appalachian groups in the Midwest and on the West Coast.

The dilemma in which MCHR activists working at free clinics found themselves illustrates a bind inherent in the MCHR's service orientation; MCHR activists began by simply asking how their medical skills could be used to best advantage on behalf of movements for social change. They thereby unwittingly imported a medical model of social change. Given the free clinics' severely limited resources, their choice was to serve a miniscule number of people in a model of humanized care, in which case the clinic was medically irrelevant, or to accommodate a greater load of patients in traditional assembly-line fashion, in which case the clinic had abandoned its original ideal of providing an alternative to mystified, alienated and hierarchical forms of medical practice. In many cases, clinics tried to do a little of both, which resulted in no one being satisfied. The simple transfer of medical expertise to the service of the movement resulted paradoxically in not politicizing health care---an objective that should be the very quintessence of a health movement.

The attachment to the counterculture and to political free clinics were both misdirected approaches in that both obscured the socially determining role played by established health institutions in distorting health care toward dehumanized services for patients and an alienated work environment for health personnel.

The Pitfalls of Guilt

During the civil rights era, MCHR militants were those who, through medical presence, allied themselves most closely with the most militant civil rights organizations. Likewise, during the late 1960s a similar identification took place, except that now MCHR militants were those who worked for the most politically "radical" free clinics. The analogy can be carried further: In both instances MCHR militants sought their identities through transference to groups that purported to represent a class, and often a race and culture as well, that were different from their own.

This search for identity through identification with society's most oppressed groups was not limited to MCHR members but was endemic to large parts of the movement. It stemmed from an unresolved and unmediated sense of guilt deriving from the activists' own privileged class and professional status. Without, however, coming to terms with this dilemma, MCHR members could not accept themselves as legitimate agents of change, much less consider the legitimacy of their own needs. The alternative for health radicals was to submerge their own needs (and hope they would not reassert themselves in too distorted a way) and to look to ostensibly more revolutionary groups for leadership. This is not to say that there is an easy resolution to the conflicting needs of these two groups---the poor, driven by their deprivation to seek material gain and inclusion in society's benefits, versus the more privileged, driven from materialism by alienation and a sense of their own impotence. At the very least a viable radical movement in America will have to recognize and deal with the needs of both groups.

Unfortunately, the tendency of the more politically aware MCHR members to define their identities through the eyes of a class other than their own led to what can only be called a compulsive need to constantly raise the ante: If political commitment was defined as service to radical groups, then one's self-assurance as a radical reguired constantly seeking out and attaching oneself to what appeared to be the most radical group on the scene. Anything less was a copout.

This dynamic meant that the MCHR was at the beck and call of whatever group could most skillfully manipulate its guilt. In 1970, for example, a group of medical students at Northwestern University Medical School in Chicago, on behalf of a coalition of political free clinics, challenged the MCHR's doctors' commitment: "...why hasn't MCHR contacted these bullshit physicians and demanded their participation?" The students went on self-righteously to demand that if the doctors refused to donate their time, "...they are to be removed from the organization." Finally, if this was not done, the Northwestern Health Collective threatened to "expose [MCHR] as a liberal front for health professionals." This psychological blackmail extended beyond MCHR doctors in Chicago. In December, 1969, for example, an MCHR statement extended the indictment to the rest of the nation: "To the people of America, we say that if the [Black] Panthers are destroyed, we are all guilty."

Aside from the personal debility engendered by the politics of guilt, there were other, no less serious, consequences. The point came when local MCHR chapter activity, like much activity of the New Left, degenerated largely into a set of political slogans and mindless rhetoric. It was apparent to many, for example, that the political free clinics could not meet the health needs of the poor and that---what was worse---their existence had taken people's attention far away from the institutions that were ultimately responsible for the denial and distortion of health services to the poor in the first place. Indeed, no amount of serve-the-people rhetoric could disguise the fact that the community people allegedly being served were, with few exceptions, disinterested in and aloof from the work being done at the most political free clinics.

The truth is that the orgy of guilt that permeated both the MCHR and the Left in general in the late 1960s had led to the divorce of political language from reality. Slogans---meant, after all, to crystallize people's comprehension of reality---instead made this reality more opaque than ever. Middle-class radicals suffering conflicts over their identity were more concerned with their own radicalism and militance than they were with the task of convincing others of the correctness of their position. An observation of Norman Fruchter on other parts of the movement applies with equal force to the MHCR: "Radicals...were rarely about to cut through their rhetoric to argue their position so that it connected with people outside the small, increasingly isolated circle of the radical left."²

The Dissolution of Self

Russell Jacoby's writings about the same years draw an even sharper conclusion, namely that the distortion of political thought and action that characterized the movement of the 1960s was not a mere accident or mistake but was the movement's rhyme and reason. According to this perspective, its rhetoric concealed the movement's driving force, which was an effort to recoup what advanced capitalistic society had taken away---the individual's very identity and personal experience, one's ability to act as the subject of one's historical destiny.³

According to this analysis, the creation of a mass of socially impotent men and women in American society ultimately stems from the expropriation by capital of the free labor of individuals, by which bourgeois society originally defined the free individual. The next stage in the historical process was the conversion by capital of these amputated individuals into a mass of supposedly free commodity buyers. But whether seen as a source of labor or as a potential customer, the individual had been robbed of the totality of personhood that alone defined his or her humanity.

The economic antidote for this dissolution of the personality has been the systematic effort of capital, with no small assist from its advertising, product design, and packaging subsidiaries, to personalize the consumer products of advanced capitalist industrial society. As depicted by Marcuse, even the most intimate of human activities, such as sexuality, is grist for the mill of commodity production and sale.⁴. Nor has medicine escaped this fate, as a glance at the ads in any medical journal will demonstrate.

This analysis accounts for much of the common dissatisfaction with a medical care system that the health movement, in particular the women's health movement, correctly perceives as being insensitive to need, bureaucratically administered, and technologically determined. Such a system necessarily drives the human element out of the patient and at the same time necessarily deprives health workers of what should be the gratification of work based on serving people in need. Both health workers and patients become interchangeable parts of technologic machinery and as such mere tools for those who control and administer the health system for profit and aggrandizement.

In response to this loss of genuine subjectivity, the MCHR, like the health movement and the rest of the movement in general, engaged in what Jacoby calls the politics of subjectivity. If monopoly capital had deprived men and women of their very selves and egos, the corrective, so the logic went, was to create a movement solely concerned with feeling, friendship, brother/sisterhood, good vibes, communality and the like. But "if the intensification of subjectivity is a direct response to its actual decline, it actually works to accelerate the decline." As the cult of subjectivity spread to every movement group, individuals became less and less able to combat the brutal objective imperative of American society to "eclipse the individual."

Paradoxically, the end result was that the two seemingly divergent movements---the countercultural and the revolutionary political---merged imperceptibly into one another. The counterculture drew its strength from its recognition, long denied by traditional Marxist/Leninists, that individuals and their alienation matter and are of political concern; it erred, however, in believing that alienation could be righted with larger doses of subjectivity or, put another way, "with just a little help from our friends." Or to follow Jacoby, "To the damaged loss of human relations it proposed more of the same."⁵ The revolutionary political movement, on the other hand, insisted that "offing the pig" and "armed struggle" were the answer, refusing to understand that sloganeering unmediated by thought and analysis does "not serve to popularize thought but replace it."⁶

Both thrusts were reverse sides of the same coin and both ultimately made the same mistakes---ahistoricism, contempt for theory and analysis and the flight from reality into wishfulness. Both parts of the movement finally opted to counter American society's drift toward the obliteration of the individual by seeking to create the experience of the individual here and now. Invariably, however, since the individual cannot now exist in society, this approach must lead to psychologizing reality, when in fact what is needed is an objective appraisal of reality. The initial need is for the development of an objective theory of subjectivity. From here one would hope for a political movement aimed at realizing the objective development of the subject.

Of course no one, either in the movement generally or in the MCHR particularly, was equipped in the late 1960s to deal with these, and many other, underlying points of theoretical confusion. Still, unless they were dealt with, it was just a matter of time until its foundations of sand guaranteed the collapse of the entire movement. These weaknesses may have been invisible to the MCHR as long as its members could believe that they were in the thick of "where it was at," but as the movements of the 1960s began to wane, the MCHR was once again left high and dry. Further, the nature of the support role by which the organization defined its existence had obscured (and possibly even created) inherent structural weaknesses in many MCHR chapters. These chapters had always drawn members in ones, twos and threes from widely diverse institutions, situations and interests. The very nature of chapter membership thus constituted an obstacle to developing an independent role for the MCHR. Beyond service and support, the question of what the MCHR should be doing seldom had an answer because it was asked of the wrong people in the wrong situation.

The MCHR's service-and-support role illuminates one last curious feature of its activity. While everyone acknowledged the importance of the organization, it had a strangely peripheral relationship to many, if not most, of its activities. Most such activities would have gone on and most MCHR members would have participated with or without the existence of the MCHR.