NORMAL AND PATHOLOGICAL HUMANITY norms according to the principle of he pushed back his and MICHAEL HAGNER ON CANGUILHEM, auto-correction, in his late essays he is explored how the organism can be seen INTERVIEWED BY CAROLINE A. JONES reflecting about the human subject that to cope with its own imperfections. It experiences its own precarious status in seems to me that this turn leads to a contemplation of death. paradox. On the one hand, Canguilhem shrinks back from the idea of an excep- Caroline A. Jones: Georges Canguilhem is known to most CAJ: You comment that Canguilhem’s tional position for homo sapiens; on the English-speakers today through the 1991 Zone translation of work can be seen, on the one hand, as a hand, he claims that humans are The Normal and the Pathological, which was published with simple history of medicine; yet you also arguably the only species that observes an important introduction by that secured its point out his broader concern with the and comments on its own physical rapid uptake here. Can you speak broadly to the importance foundations of all organic life. Would decline. you ascribe to the later work of Canguilhem, which is not as Foucault have too narrow a view of well known? Canguilhem as uniquely concerned with CAJ: Can you speak to the significance the human? With understanding how of Canguilhem’s completing his doctor- Michael Hagner: The Zone edition made Canguilhem’s book the normativity of “health” is regulated ate with The Normal and the Pathologi- famous, but the English translation of The Normal and the in the human? Or, as you explore in your cal during World War 2 (it’s published in Pathological was in fact first published in 1978, already with introduction to the German publica- 1943)? You discuss his politics as partly a Foucault’s introduction. In that very influential text, Foucault tion of these texts, is Canguilhem more function of disillusionment with the inef- argued that Canguilhem developed a philosophy of error, of engaged with organisms or beings more fectuality of the Resistance under Vichy. concept, and of life against a philosophy of sense, of subjects, generally? What about the corruption of medicine and of experience. The latter one was represented by phe- as a Hippocratic practice during the nomenology and , mainly through Sartre and MH: In his introduction, Foucault is Reich, would this have been something Merleau-Ponty; the former one was the rationalistic tradition primarily concerned with Canguilhem’s he was aware of? of Bachelard and Canguilhem, into which Foucault integrated historical epistemology. He emphasizes himself. What I find striking – and what motivated me to write Canguilhem’s insight that it would have MH: I do not know under which condi- an afterword to his later essays1 – is that Canguilhem pub- been impossible to constitute the sci- tions Canguilhem defended his medical lished most of these essays on medicine after 1978, after Fou- ences de la vie by the end of the 18th thesis in 1943, but the question, which cault’s introduction. In these texts Canguilhem did not quite century without taking into consider- traces were left in his writings by the turn into an existentialist, but – perhaps feeling plagued by ation disease, monstrosity, anomaly, occupation of through Nazi his own age, (he was born in 1904) – he reflected about basic or death. Therefore, medicine is a most Germany and the Vichy Regime, and questions of medicine, such as health, cure, the concept of important field for the epistemology of by his engagement in the Résistance nature in medical theory and practice, the power and the limi- the life sciences, yet Foucault would not and the assassination of his friend Jean tations of rationality in medicine – and, of course, the human. argue that Canguilhem is mainly con- Cavaillés through the Nazis, is a mat- These essays use examples from history, but in these texts cerned with the human. Canguilhem is ter of particular interest for me. This is Canguilhem’s perspective is that of a of medicine. neither a phenomenologist nor does he because, in very general terms, I would This is a dimension in his œuvre leading beyond his episte- develop an anthropocentric philosophy. say that the history of 20th century mological and his historical interests. Whereas in The Normal For him, any human activity, be it sane epistemology and Science Studies can and the Pathological Canguilhem argued that organisms, in or insane, is ultimately an expression only be understood as a product of its the status of health as well as in that of disease, set their own of the specificity of the organism. In his face-to-face confrontation with politi- epistemological writings, Canguilhem cal in those days. As far

1 See Michael Hagner, Georges Canguilhem und das Problem der Medizin, wanted to understand the ways in which as I know, Canguilhem did not directly in: Georges Canguilhem, Schriften zur Medizin, tr. by Th. Laugstien. Zürich/ this organismic specificity is conceived thematize the unique barbarism of medi- Berlin: diaphanes 2013, pp. 115-143. Canguilhem’s essays have also recently in the historical development of sci- cine and biopolitics in Germany, but his been translated into English: Georges Canguilhem, Writings on medicine, tr. and with an introduction by Stefanos Geroulanos and Todd Meyers. Ford- ence and medicine. In his late writings, experience under Vichy and the Nazi ham University Press 2012.

100 Caroline A. Jones 101 Normal and Pathological Humanity, Michael Hagner on Canguilhem bernetic paradigm after 1945 was that MH: True, for Canguilhem, the concepts its machine-centered universalism was of auto-correction and self-regulation seen as a welcome remedy against the are the most important mechanisms for organism-centered stigmatizing typol- the living being. He took these con- ogy of eugenics.2 Hence, I was quite cepts from the German neurologist Kurt relieved, when I learned that Canguil- Goldstein, who characterized health and hem rejected any analogy between the disease as two modes of relationship organism and society. In his speech to between an organism and its environ- the French organization of the Alliance ment. He also adopted Walter Cannon’s israélite universelle, in 1955, Canguilhem theory of homeostasis. Despite all their was fully aware of the political back- differences, these two theories (of auto- ground that would be supplied for any correction and homeostasis) can be seen discussion of “the issue of regulation in as versions of systems theory, which the organism and society,” yet he did not have some striking similarities with mention eugenics explicitly. This silence cybernetics – though the latter has its may come as a surprise, but I would ar- reference point in self-regulating ma- gue that it is merely the discretion of the chines and computing devices, whereas epistemologist, who works with concep- the former has its reference point in the tual clarification rather than with particu- biological organism. Canguilhem was lar reference to historical acts of terror- certainly interested in cybernetics, yet in ism and barbarism in order to reject that his seminal 1947 lecture and paper on equation of organism and society. In “Machine and organism” he argued that the organism all elements exist for the organisms should serve as models for good of the whole, but there’s nothing building machines, and not vice versa.3 like this self-regulating system in society. This was against the mainstream at the The living individual is characterized by time, and I am quite sympathetic with self-regulation and homeostasis, society this view, because it prevents us from is not. Society, invented as a tool for the technological determinism and the odd Copyright the Club Philo du Lycée de Sèvres : welfare of human beings, is in a notori- idea of conceiving society as a cyber- http://www.coin-philo.net/p_canguilhem.php ously endangered state, the organism is netic feedback mechanism. not, unless it is afflicted by sickness. occupation certainly had consequences CAJ: In your text accompanying the CAJ: What happens, when sickness for his thinking. We can clearly see it, for German translation of these writings, CAJ: You identify the relationship be- comes into play? example in his haunting warning against you comment specifically on the devel- tween “Self-regulation” and “precarity” equating society and organism. He opments of eugenics and cybernetics in in the later Canguilhem. You often use MH: Sickness disturbs the functional agreed with US physiologist Walter Can- confrontation with what it means to be the phrase “Auto-correct”… you must be equilibrium between the organism and non that there is a wisdom of the body, human in the 20th century – this is how conscious of its computerized analogy? its respective environment. The organ- but he rejected the idea that there is that warning against an “organismic What is the role of mechanism in Can- ism is pushed to reset itself on a reduced something like a wisdom of society. This society” takes shape, yes? guilhem’s theory (and your own)? functional level. Instead of abundant position was certainly a consequence of self-realization simple existence be- his experiences in the age of extremes MH: In my own work on the history and, as I should like to add, contrasts of twentieth century brain research I 2 See Michael Hagner, “Bilder der Kybernetik: 3 Georges Canguilhem, “Machine and Organism” with current flirtations with the “wisdom argued a couple of years ago that one Diagramm und Anthropologie, Schaltung und (1947), translated from the French by Mark Nervensystem”, in: idem, Der Geist bei der Ar- Cohen and Randall Cherry in Jonathan Crary of the crowd,” for example. explanation for the success of the cy- beit. Historische Untersuchungen zur Hirnforsc- and Sanford Kwinter, eds., Incorporations (New hung (Göttingen: Wallstein, 2006): 195-222. York: Zone Books, 1992): 44-69.

102 Caroline A. Jones 103 Normal and Pathological Humanity, Michael Hagner on Canguilhem comes the new standard. But even in MH: I think it is useful to distinguish more robust faith in autopoeisis and MH: Right, this is the moment when this reduced state, auto-correction func- between his writings from the 1940s, the self-correcting mechanism. It’s the singularity of man comes into play. tions; it operates as the organism tries in which he was relying on systems somewhat absurd to talk about psycho- Since overly instrumentalized medicine to establish a new equilibrium, attempt- theory of disease, and his late essays, soma in the woodlouse – although we and psychosomatic medicine and natu- ing to restore adequacy at a lower in which he was concerned with other certainly use the grey mouse to study ropathy challenge Canguilhem to criti- level. There will either be recovery or issues. In fact, he did not engage in de- anxiety’s deleterious effects! cism, then what’s left? Here we recall what Canguilhem calls “the emergence tail with new developments in molecu- that he is a philosopher asking basic of a new order of life.” Disease marks lar biology, immunology, organ trans- MH: The non-human powerfully bal- questions about human existence. To the dynamic field between precarity plants, etc., and some commentators ances his theories of the human or- put it in his own words: “The existence and auto-correction – neither fully one have blamed him for this lacuna. They ganism. Canguilhem reminds us of of disease as a general biological fact, nor the other. This liminal state prevails see Canguilhem’s late essays as cow- the Hippocratic self-regulating body, and in particular an existential test in until the ultimate precarity, which is ing to certain fashionable arguments but hints to a major . Self- humans, raises the not yet convincingly death, about which Canguilhem has against the mechanization of medicine regulation in the late 20th Century may answered question about the precari- almost nothing to say until a specific at the time. Indeed, he bemoaned the no longer have the same meaning as in ousness of organic structures”.5 moment in the very late texts. increasing replacement of doctors’ the times of ancient medicine, because This “precariousness” is crucial to the clinical knowledge of the body with the norms and value orientations have late writing. It is when Canguilhem CAJ: Would this drive to equilibrium computer readouts. In an age when shifted. This is where the radicality of addresses not just the pathological (even in the face of death) be character- medicine itself had moved away from the original doctoral thesis, The Normal but disease in all of its voracity that he istic of all life? Or does the human ca- the organism (and became in a sense and the Pathological, returns. There brings in Freud with his concept of the pacity for higher consciousness render less reliant on “humans” for its prac- is an historical framing of the human as inherent to the biological it exceptional? tices), Canguilhem rarely failed to take and its autocorrecting functions—the organism. (Now scientists have identi- a swipe at such a situation in the later concept of health functions to set stan- fied this “programmatic drive” even MH: In this respect, humans are not ex- texts. But at the same time he categori- dards, and as such it thus depends on at the chromosomal level, in the dwin- ceptional. Living things identify, evalu- cally refused to join in the critiques of the context in which it is defined and dling telomeres.) There is a wonderful ate, set norms, figure their environment medicine at the time. structured. The capacity for some kind passage in an essay that is not included – it is the same with men and animals, of health lies in the organic system, in the “Writings on medicine”. In this even if monkeys have developed no CAJ: What kinds of critiques were but the particular design of what that text, Canguilhem cites Freud on the medicine. This is a kind of philosophical these? health is, cannot be separated from the death drive – but it is not a citation to anthropology in which the critique of concrete historical situation. Accord- Freud’s famous papers or lectures but anthropocentrism is clear: there’s not MH: Well, radical authors such as ingly, the auto-corrective forces of the to a personal letter that the psycho- such a big difference between the hu- Ivan Illich made searing critiques of organism have to be seen in relation analyst wrote about his own aging.6 In man and other. As Canguilhem puts it, medicine in the 1970s, and advocated to the diagnostic tools and therapeutic this personal musing, the elderly Freud humans “do not inhabit a higher level returning health practices to the hands power of medicine in a given historical (who would die of a ravaging mouth of reality than the milieu of the wood- of the people – essentially alternative or context. For example, it does not matter cancer) longs to no longer need to hold louse or the gray mouse…”. folk healing.4 Canguilhem felt this was if psychosomatic medicine can explain things together, but to let them drift to premature, that the psychosomatic ac- the nature of a given disease – what the inorganic. It is no coincidence that CAJ: In the 1940s, of course, Canguil- tually explains very little about the way matters is whether anything psychoso- hem was writing before the revolutions organisms heal themselves. matic can be an effective practice. 5 Georges Canguilhem. Writings on Medi- cine. New York: Fordham University Press, in molecular biology that transformed 2012. http://muse.jhu.edu/ (accessed Decem- medicine after the 1960s, and even in CAJ: Is this because he is thinking CAJ: Neither can health and disease be ber 30, 2013), 41. 6 Georges Canguilhem, „Macht und Grenzen the later writings he resists some of the about more than the human? His wider separated from a much more personal der medizinischen Rationalität“, in: idem, implications of those new domains. view of the organism gives him a much situation, if I read you correctly. As you Grenzen medizinischer Rationalität (Tübingen, point out, for Canguilhem, in the end, edition diskord, 1989), 67. Canguilhem refers to Freud’s letter to the Swiss clergyman and 4 See Ivan Illich, Medical Nemesis. London death comes into view. psychoanalyst Oskar Pfister from 11 October 1974. 1925.

104 Caroline A. Jones 105 Normal and Pathological Humanity, Michael Hagner on Canguilhem this kind of thinking appeals to Can- guilhem puts the experience of our is hopeless and yet be determined to cal practice.10 Even if we may smile guilhem, who is himself experiencing own perishability into the center of do something about it.”9 about such an old-fashioned European dwindling forces. Now, the finiteness his late essays does not mean that he humanist position, I would argue that of life is the point: “Death is in life, returns to anthropocentrism. Canguil- CAJ: Can there be a contemporary neither the connection between local disease is his character”.7 hem is of no use to phenomenology, Canguilhem in ? experience and statistical probability, in this respect Foucault is perfectly Is it precisely the humanist, mortal nor the question of the relationship CAJ: Again, given our interests in this right. Yet he was not so much aware of theorist of these late writings that we between the doctor and the patient is issue -- is this specific to the human? the convergence of epistemology and should be reading? solved in our age of bio-techological (patho) Anthropology in Canguilhem’s medicine. And given all those discus- MH: Largely. My reading of Canguil- late essays, which wanted to come to MH: Some commentators have ut- sions on cyborgs and posthumanism, hem is that he sees man as the smart terms with our own expiration. tered disrespect for Canguilhem’s late I find it healthy when Canguilhem re- animal that perceives and interprets essays by emphasizing two criticisms. minds us that we are those smart ani- the decline of his powers and looks CAJ: Does that expiration remove the First, as we’ve discussed he did not mals in a remote corner of the cosmos death in the eye. Freud comes in here human from the animal, by virtue of carefully consider recent scientific who have not only invented gnosis as arguing for the authenticity of ill- that very consciousness of one’s drive developments such as the molecular- – as Nietzsche put it–,11 but who also ness and disease in the dissolution of to die? The yearning to “drift to the ization of medicine; and second, he have to realize our own death. It was organismic identity. All that leads to organic” or a merging of energies with explicitly rejected certain aspects of quite illuminating for me to dig into our resigned acceptance of death. We entropy? modern medicine. Indeed, Canguil- these later publications, where we can are dealing here with a massive shift hem – like the philosopher see Canguilhem sitting side-by-side of perspective for Canguilhem: for the MH: The inevitability of death is con- – did not accept the criteria of brain with Freud and his idea of thanatos. human, life is a life unto death. Health stitutive for all living beings, but we death, and in one of his last texts, he These are expansions to the brilliant is never complete and permanent, and are arguably the only ones who under- was horrified by the perspective that insights about the normal and the the way to its end is inevitable. stand and try to overcome that en- the experience and judgment of the pathological that make Canguilhem’s tropy. The cyborg fantasy (that is, the doctor were more and more replaced late writings on medicine crucial read- CAJ: That is a remarkable develop- immortality of machines or substitute by a computer-generated diagnosis. ing for theorists (and practitioners) of ment for the theorist of the normal organs)… Canguilhem did not directly refer to the human. and the pathological. These would be the monoculture of computational considered binaries in the early work CAJ: …or, in our age, the related “evidence-based medicine,” but it – mutually constitutive opposites that (if bizarre) dream of becoming im- is remarkable that a contemporary determine each other in a clinical sys- mortal through a data-upload or commentator such as Richard Horton, tem. Yet it appears that in these later “Singularity”8 the editor of Lancet, again and again works they merge with one another as refers to Canguilhem in his rejection the inevitable function of life: to even- MH: These would offer no escape for of this polemical force against clini- tually twine into disease and death. Canguilhem. Quoting F. Scott Fitzger- ald, he conceives of our knowledge 10 See e. g. Richard Horton’s review of the MH: This surprising turn to Freud in of death’s inevitability as like holding recently published translation into English of some of these same late essays (note 1), the late works can be seen as a disil- two incompatible ideas in mind and Canguilhem’s Writings on Medicine in Lan- lusioned diagnostician who takes up continuing to function: “You should be cet 380, September 8, 2012, p. 872; as well as his earlier essays on such as idem, “Georges another old doctor as a mouthpiece able to recognize, for example, that all Canguilhem, philosopher of disease,” for his own position, bringing together Journal of the Royal Society of Medicine 88, 9 This quote is on the last page of the essay 1995, p. 316-319, and idem, “Rediscovering concepts and experience, illness and 8 Ray Kurzweil, The Singularity is Near: When “Is there a pedagogy of healing?”. Canguil- human dignity,” Lancet 364, September 18, fatigue, decay and death, to be ad- Humans Transcend Biology, (New York: hem quotes from F. Scott Fitzgerald’s late 2004, 1081-1085. equately reflected. The fact that Can- Penguin, 2005), argues that ultra-intelligent short-story “The crack-up.” Georges Can- 11 , Über Wahrheit und machines will allow humans to overcome the guilhem. Writings on Medicine. New York: Lüge im aussermoralischen Sinn, in: idem, limits of biology through mechanisms that Fordham University Press, 2012. http://muse. Sämtlich Werke, vol. 1, Munich, Deutscher 7 See footnote 5. are mystical as much as technical – so far. jhu.edu/ (accessed December 30, 2013), 66. Taschenbuch Verlag 1980, pp. 875-890.

106 Caroline A. Jones 107 Normal and Pathological Humanity, Michael Hagner on Canguilhem