"Why do you assume you have the right to decide for someone else? Don't you agree it's a terrifying right, one that rarely leads to good? You should be careful. No one's entitled to it, not even doctors." "But doctors are entitled to that right - doctors above all," exclaimed Dontsova with deep conviction. By now she was really angry. "Without that right there'd be no such thing as medicine!"
Alexander Solzhenitsyn wrote that in Cancer Ward, first published in 1968. On the surface, the novel is a slice of life story set in a hospital. The semi-autobiographical central character, Oleg, is surrounded by an array of other patients undergoing treatments, mostly ineffective, for a terrifying disease. The nurses and doctors are overwhelmed, managing their frustrations with a mix of bravado and despair. The only true victor in the novel is cancer.
But the book is also a metaphor for society. Solzhenitsyn designed the metaphor to capture what was happening in the Soviet Union. But the book can also help us examine American society in the Age of COVID. Solzhenitsyn helps us understand the answer to a question that has surely crossed many minds since 2020: how did a biological disease turn into a political battle?
At first, the book's metaphor seems fairly straightforward. Cancer is a disease affecting many patients. Doctors and nurses work in the hospitals to minimize the damage done by the disease. As a political metaphor, then, cancer stands in for some kind of social affliction, and the role of the state, the political hospital, is to cure society.
But this is exactly what Solzhenitsyn is critiquing: the seemingly unremarkable assumption that the doctors have the right to decide what is best for the patients. When this metaphor is brought to bear on politics, it suggests that political leaders can assume the right to decide what is best for the population. Reread the quotation above and change "doctors" to "legislators." This, Solzhenitsyn reveals, is a recipe for violent totalitarianism. Imagine a sharp, articulate young leader coming to power, seeing the problems in society, and promising the competence to cure them. Who could resist the thrill of fixing society's problems through an energetic and unilateral government power?
In the story, doctors had discovered that X-ray radiation treats cancer. The hospital used radiation liberally, without foreseeing that radiation carries with it deadly side effects. "[T]en, fifteen or eighteen years ago, when the term 'radiation sickness' did not exist, X-ray radiation had seemed such a straightforward, reliable and foolproof method, such a magnificent achievement of modern medical technique, that it was considered retrograde, almost a sabotage of public health, to refuse to use it. . . ." Solzhenitsyn adds, "So - they irradiated! They irradiated with wild enthusiasm! Even benign tumors. Even small children." The seeds for widespread radiation sickness had been planted.
Eventually, as patients with radiation sickness filled hospitals, it became clear that radiation was not a cure but another disease. Political "cures," Solzhenitsyn shows us, also produce secondary and more sinister social dysfunctions. By the late 1960s, when Solzhenitsyn was writing his book, the Soviet state's damage to the body politic was obvious. The state violence is mirrored by the bodily violence described in Cancer Ward : "And now these children had grown up. Young men and women, sometimes even married, were coming with irreversible mutilations of those parts of the body which had been so zealously irradiated." Robert Conquest's The Great Terror , documenting the massive death toll of Stalin's reign, was published the same year as Cancer Ward . Solzhenitsyn's The Gulag Archipelago was circulating underground. The political climate of fear and mass slaughter made it impossible to believe that the Soviet experiment was working.
If you think seeing the damage inflicted by their aggressive measures would induce second thoughts among the political class, then you have not spent enough time studying zealots. If the treatment failed, the problem must be the patients, not the treatment. The state looks out at the people and, like the doctors in the novel, explains that the reason things have failed to date is that the people have omitted "one essential condition: you must accept your treatment not just with faith but with joy ! That's the only way you'll ever recover!"
But if state leaders, the doctors in the social hospital, do realize that their interventions produced even greater harm, they work to make sure nobody notices. Solzhenitsyn writes, "Of course no one told the deformed youth or the cheated mother that they had been incorrectly treated as children. . . . Such an explanation . . . might have done great harm to health propaganda among the population." Admitting failure would erode the absolute faith in the state's competence on which the political apparatus depended.
Diagnosing how the political class has internalized the idea of politics as medicine is the first part of Solzhenitsyn's argument in Cancer Ward . But he also examines what happens when the population also buys into the idea of politicians as society's physicians. Solzhenitsyn spells out the troubles that emerge when the ruling class and the population are united in thinking that political leaders hold the cure for social ills, even when the leaders' failures are manifest. Solzhenitsyn's insights, as we will see later, bear directly on the confusions and delusions of our COVID-era politics.
People who live in societies with weak social bonds and without nonpolitical sources of authority are more susceptible to the allures of a powerful state. Solzhenitsyn writes: "[L]et's call it a more refined form of the herd instinct, the fear of remaining alone, outside the community . There's nothing new about it. Francis Bacon set out his doctrine of idols back in the sixteenth century. He said people are not inclined to live by pure experience, that it's easier for them to pollute experience with prejudices. These prejudices are the idols." There are many phenomena that we cannot understand through our own experience, so sometimes we must rely on the authority of others. Tribes can powerfully provide answers to reality's more obscure features - but they present idols to their members and play on people's fear of rejection to keep them obedient. Once you join your tribe, you conform, even though you don't quite realize that you're conforming. But you do notice how all the people outside your tribe have become slavishly obedient to their own misguided tribal leaders.
Everyone has their idols. What are these idols? First: "The idols of the theater are the authoritative opinions of others which a man likes to accept as a guide when interpreting something he hasn't experienced himself." People go to the theater to watch others solve the problems presented in the play. The audience does not participate in finding the solution; it merely observes and applauds those who are on the stage. Solzhenitsyn could not have imagined how accurate this would become in a world where the number of those offering authoritative opinions is legion, each of whom can perfectly tailor those opinions to attract a horde of people looking for a guide.
How strong is this impulse to believe your authorities are the right ones? Solzhenitsyn explains, "Another idol of the theater is our overwillingness to agree with the arguments of science. One can sum this up as the voluntary acceptance of other people's errors." When a society descends into tribalism, truth becomes secondary to obedience to the group leader, even when the leader is in blatant error. Leaders with medical and scientific credentials are particularly effective at commanding obedience: science is supposed to be objective, clear, and indisputable. And when scientific expertise is combined with political leadership, it is no wonder that tribes defined by scientism treat the state like a physician. Various tribes and their idols pave the way for the terrifyingly opaque and powerful image of the physician-state depicted in Cancer Ward.
Solzhenitsyn's book can help us understand some of what happened when COVID became a political firestorm. The virus quickly became a concern for the state. Various governmental authorities were suddenly designated with the authority to dictate how to respond to the disease, and many people accepted those decisions as legitimate. Our government became a physician for an actual illness and adopted vast authority for itself.
While the Soviet Union presented a single, state-enforced tribe, our COVID-era tribes are largely dispersed. Even though certain views of the disease received a state imprimatur through the CDC recommendations, there were many contesting views of the virus from the beginning. Everyone instantly became a scientific expert by deciding which set of scientific authorities were the only true scientists. When the scientists at the CDC and the scientists who signed the Great Barrington declaration disagreed, everyone knew which group was the real scientists and which group was people just engaged in political theater. Suddenly, everyone had scientific expertise on biology and mathematical models of infectious diseases and thus knew which set of scientists were right. It was only the other side that was denying the science.
Our constitutional government makes it extremely difficult for the state to assume the totalitarian form that Solzhenitsyn experienced and wrote about in Soviet Russia. The divisions of our tribes keep one group from maintaining power long enough to stamp out its competitors. Nonetheless, many seem to cling to a physician-like view of our government: the state, married to scientific expertise, deserves deference. And our tribal tendencies that facilitate unhealthy deference to the state are in themselves sources of social dissolution. As long as we continue to be blinded by our tribe's idols, authorities will only escalate their manipulation of information and use of power.
Solzhenitsyn's work is not without hope. While society and the state may be diseased, individuals still have the power to rise up above it all, to stop worshiping their idols and leave their tribes. In the penultimate chapter, Oleg, with his cancer in remission, leaves the hospital and heads home. The chapter is entitled "The First Day of Creation. . . ." The world is seemingly made anew, a fresh beginning.
But it's only a partial triumph. Outside the hospital is a world lacking community. By leaving the hospital, the patient is free but isolated from other people. In the final chapter, ". . . And the Last Day," Oleg lays his head down to rest and realizes that the world is not cured: "It was only then that in his heart, or his soul, somewhere in his chest, in the deepest seat of his emotion, he was seized with anguish." To leave the tribe, to abandon the idols and see the theater of it all, does not cure the society.
Diagnosing the problem is only the first step. For a society to function well, something has to replace the idea of the legislator as physician. Extending Solzhenitsyn's metaphor just a bit, a healthy body politic needs to develop systems that fight back social ills instead of instantly calling the legislative physician.