Teaching Tuesday: Health, Morality, and Learning

Lately me interactions with doctors has increased. I suppose this is the inevitable result of aging combined with the growing view of health as matter of public as well as private concern. Like most people, I dislike having health issues almost as much as I dislike going to the doctor. The more that I’ve had to go to the doctor lately, the more I’ve come to appreciate how the doctor-patient relationship has obvious parallels with the relationship between students and teachers. I know that I’m not the first to observe this.

My experience with health care and my experience in the classroom were the same through most of my life. Not only am I generally intimidated by the process, but I also disliked being told that that my failures in learning and my health challenges were most likely my fault (even if I am now mature and humble enough to recognize that this was probably the case). My recent experiences with health care suggest that this trend has not changed. While my current health issues are comparatively minor, there is certainly no doubt in my interaction with my health professionals that they are the result of some moral failing evident in my diet, my recent and past lifestyle choices, and my overall irresponsibility. Having health problems, then, is a kind of somatic accountability. Health care both in the past and in the present is a totalizing discourse that exposes both our public, and our private lives to scrutiny and judgement. In practice and in my experience, I’ve learned that I’m sick because I was bad.

(It goes without saying that this moralizing approach to medical care is very old with precedents in antiquity. I also know that my experience as a middle-aged, white, male is no where near as intrusive, judgmental, or moralizing than if I were poor, struggling with addiction, queer , or, say, a Black woman.

I also suspect that the health care has become more moralizing since the COVID pandemic. On this very blog, I argued that low vaccination rates in states like North Dakota, Wyoming, and various southern states represents aspect of “structure violence” associated with deliberate and historical strategies of “development of underdevelopment” in these regions. Rather than being a clarion call for greater investment in the populations in these areas from the traditional political, social, and economic core, it became an opportunity for political posturing, polarization, and moral critique.

This, of course, reinforced the structural violence by encouraging unscrupulous actors to represent the moralistic rhetoric coming from the core [often manifest in the “lame stream media”] as every bit as toxic [paternalistic, and misguided] as the vaccinations themselves. Thus efforts to protect the bodies of individuals in states historically located at the political, social, and economic periphery, became another tool designed to control the bodies of individuals in these communities. By echoing the rhetoric of individual accountability, critics of vaccination programs further weakened the social fabric of these communities and their capacity to resist future pressure from the center.

Of course, current debates over, say, gender-affirming care offers further opportunities for moralizing and echoes in tragic and painful ways moralizing responses to the AIDS epidemic. To be clear, the point of this post is neither to trivialize the deep trauma causes by a health care system whose ties to capitalism all but ensure a deep commitment to Christianity nor to compare classroom struggles to the way in which contemporary health care has failed our many of the most vulnerable.) 

Over the past decade, I’ve been exploring ways to encourage students to see learning not as an individual enterprise (reinforced by individual grades), but as a social enterprise. In some cases, my efforts are not terribly subtle. For example, I have tried to center group work particularly in my introductory level courses. In other classes, I’ve shifted some of intellectual “heavy lifting”: textual interpretation, thesis building, and evidence gathering to work done by the entire class rather than by the individual. Certain aspects of the work — writing, for example — remain individual, but the class itself remains centered on group work as a way to reinforce the idea the learning is a collective, communal, and even social undertaking.

Part of this move, however, involves me thinking more deliberately about individual accountability. In learning as in medicine, the rhetoric of accountability seems to have become more prevalent. Students now regularly acknowledge their accountability for things like missing class, late assignments, or — more troublingly — poor performance on grades assignments.

I always find this rhetoric disappointing because it not only collapses the complex social process of learning into an individual’s capacity for success or failure, but also makes clear that I have not been entirely successful in my effort to decenter the individual in the classroom.

It would seem that learning is much like receiving medical care in this regard. On the one hand, we experience our health in somatic (and psychological) ways and this offers a clear parallel to way in which experience learning. On the other hand, we know that our health and our learning are not only individual experiences, but also exist as a social phenomena that depend on institutions, practices, and structures which go well beyond the individual.

My experience in health care in the New Year has reminded me that despite our efforts to recognize the social context for health and learning, there remain powerful pressures to present our limitations and inadequacies not as responses to a problematic system, but as personal failures. While our health care system is likely to remain dysfunctional and my personal discomfort is pretty inconsequential in greater scheme of things, how I approach and respond to challenges in my classroom feel like something that I can address more thoughtfully than I do now. While I’d hate to assert that I have a moral responsibility not to penalize students from behaviors resulting from structural violence, I do recognize that by internalizing standards set by a broken system, I am not doing as much to affect change as I could.