Politics Foreign Affairs Culture Fellows Program

Masks As Condensed Symbols

On liberal hegemony within institutions, and conservative hatred of expertise
Rally Held At Pennsylvania State Capitol To Urge Governor To Open Up Lockdown Orders

Great e-mail from a reader:

Surprised that in your (very helpful) commentary on masking, you haven’t mentioned this, since it was a big part of your writing about a year ago.  To me, it seems as though masking (or not masking) is the ultimate condensed symbol.  It’s the bog Irish doing their Friday fast.  It’s not really about what they do or don’t believe about masks, it’s about stating their non-eliteness.  This has led me to a couple of thoughts.

Before we get there, let me remind readers that the anthropologist Mary Douglas famously wrote that the Catholic fish-on-Friday requirement was, for Irish laborers living in London, an important symbol of what set them apart from others. The Catholic Church leaders who did away with the Friday fast during the 1960s reforms may have had very good theological reasons for doing it, but they unintentionally (says Douglas) destroyed an important “condensed symbol” of identity, in the eyes of the workers. Read this post to learn more.

Back to the reader’s letter:

One is that a lot of the more thoughtful mask-skeptics are treating this as an ideological discussion and not as an actual, life-and-death issue, which I think is very emblematic of Ross Douthat’s decadent society–we can’t rouse ourselves out of this torpor where everything is theoretical and slotted into endlessly recycled partisan internet fights.  I had a fascinating conversation about this with a friend of mine, maybe the smartest guy I know.  He has a Ph.D from an elite university, very widely read, the kind of guy who knows his Burke, Augustine, Aquinas, and Locke far better than I ever will.  He made points I thought were reasonable and compelling–that in western culture, covering the face has long been taboo, that masking gets in the way of a deep human need for facial cues and will have unpredictable consequences for human interaction, and that mask culture is deeply intertwined with a sort of progressive scolding that’s off-putting.  All these were points I resonated with very much–but they were all entirely theoretical and seemed rooted in a conceptualization of normal that just isn’t here anymore.  Like the virus gives a damn that masking feels like giving in to statist scolds, or that it doesn’t work well with western culture.  This has marked a lot of conservative discourse on the topic to me–everything has to be about the pink police state, or the obnoxiousness of masking scolds, as though we are just debating on Facebook and not in a literal once-in-a-century crisis that’s killed almost 100,000 people in 9 weeks.  A lot of the conservative takes I read offer these theoretical arguments but then on the level of actual “does masking work?” data, the quality declines precipitously.
The second is that there’s a vicious cycle of institutional liberalism in public health, indeed, in public EVERYTHING.  For reasons that are understandable and sometimes legitimate, conservatives (especially here in the USA) tend to reject whole swathes of public policy as just illegitimate on their faces–things that should be left to the private sector, or individuals, or what have you.  So because conservatives aren’t interested in environmental policy, public health, etc., they cede those fields to progressives, which means those institutions develop progressive biases, which both repels potential conservative workers and makes it harder for them to advance, which increases progressive bias, and so on.  And when conservatives DO get the chance to helm these organizations–and this is where Trump infuriates me more than almost anything else–instead of putting serious thinkers with a body of work and experience into those positions, they put in grifters or people who intentionally dislike the institution and want to weaken it.  In some areas, this is an understandable if sad dynamic.  But public health has been viewed as part of the magistrate’s job for as long as war and courts.  Governments have been quarantining infectious disease since well before the United States existed.  It is a CRUCIAL field, and it has to function, and conservatives cannot just bitch about how “well it’s full of liberals and has a liberal bias.”  Yeah, public health will institutionally be biased a bit towards statist, central action.  It will be skeptical of religious institutions as partners.  But your county health department is as vital to your community as your local school district or police, and by ceding fields like public health to the progressives, conservatives have basically lost all institutional knowledge about things like public health.  There is no viable conservative alternative to public health in this crisis–the entirety of it is “bunch of libs doing lib stuff!  No to that!”
This is also a symptom of how functionally libertarian our right-wing politics have become.  Guys like Bob Dole seem like dinosaurs from another era–and yet I feel like only 20 years ago plenty of conservatives would have acknowledged that in times of epidemic, war, or terrorism we might need a muscular government response.  But the ensuing decades of conservative brain rot–from Bill Buckley to Sean Hannity–have resulted in a movement that seems incapable of doing anything other than 1) protesting the libs and 2) asserting their rights to do what they want.
What it boils down to me is that apart from the military (which I think we could do with less of), the judiciary, and law enforcement, there’s essentially no conservative institutional knowledge.  No conservative sense of what public health, or environmental protection, or workplace safety regulation, or consumer finance protection should look like.  Everything has degraded into your “folk libertarianism” except for poor lonely Mitt Romney, and Josh Hawley who I’ll believe just as soon as he does something more than make an inspiring speech.  Michael Lewis had a good, if somewhat overwrought (or so I thought at the time) book, “The Fifth Risk,” published after Trump took office, and it illustrates this really well.  The idea basically is that the worry is that institutional knowledge and competence will degrade, under leaders that deride expertise, and some unforeseen future crisis will arise that no one will have the capacity to deal with.  And here we are.
What a bizarre situation: conservatives as the ones who have failed to preserve institutional knowledge.
The reader really hits hard on these two related issues: institutional capture by technocratic liberals, and conservative resentment of expertise.
Liberals really cannot grasp the extent to which they have allowed their cultural politics to dominate the institutions they lead. In my forthcoming book, I feature parts of an interview I did with a Soviet-born physician, now living and working in the US, who says at at his hospital, the leadership has ordered the doctors to give patients who want to change their sex whatever they want. This, even if in the judgment of the physician, transition is not the best way forward for that particular patient. It’s 100 percent about cultural politics. The doctor told me that it wasn’t this bad in the Soviet Union, that despite their ideological craziness, the Soviets would not have gone so far in applying ideology to medicine.
The doctor said that the problem is that in the medical profession today, its leaders have thrown out the old definition of “health,” and replaced it with “well being.” Health is something that can be objectively measured. Well being is entirely subjective. If you, as a physician, object to this, your career will be over. Ask Dr. Allan Josephson. This kind of thing is everywhere.
Many liberals today have a hard time discerning the difference between science and politics. Conservatives see this a lot. They don’t see the extent to which politics (cultural and otherwise) play a role in interpreting data. In the Victorian era, both British imperialists and British abolitionists seized Darwin’s findings and said that Science clearly shows that the things they already believed were scientifically valid. The authority Science had in the 19th century (and still today) meant that if you could convince people that the thing you believe was scientifically true (whether it was or not), you were thought to have won the argument.
But they are sometimes wrong, and common sense is right.
Except when it isn’t. The “folk libertarianism” in American life is not restricted to politically-minded contemporary conservatives.
My late father was a public health officer in his first career. He worked in the rural South. I remember as a child how frustrated he would be at times with the persistence of people’s ignorance about sanitation. Here’s a funny story that’s true. Once he received word from a utility worker that a particular rural family was keeping live hogs inside their house. My father knew the family, and thought he had better go have a word with the old farmer (“Mr. Jones”), to advise him about the health risks of this. As he sat in the kitchen with the old farmer, the farmer’s wife scraped lunch plates into a foot tub, walked across the hallway that bisected the house, and opened a door. My father heard hogs squealing. She tossed the scraps at them, then shut the door.
My father kept a straight face, and said, “Mr. Jones, it’s not sanitary to keep hogs in the house.”
Farmer Jones said, “Well, Ray, I don’t know about that. I ain’t lost one yet.”
That really happened. My father got nowhere, because the old man was not going to trust what the public health expert said when it contradicted his experience. That was really dumb.
But it wasn’t just simple country people. Once he had to work as part of the state’s public health team at the woebegone Celebration of Life, a Woodstock-style rock festival on the Atchafalaya River. It turned into a real disaster. He said that there were some really unscrupulous vendors there trying to make money off the stoned-out-of-their-gourds hippies. My dad condemned an entire truck full of fried chicken which had been sitting out in the heat uncovered four hours. He said that if the concertgoers had eaten it, they would have been very sick, and might have died. When he seized the chicken, though, my dad had to deal with a growing mob of hippies, though, who thought that the Man was just trying to keep them from eating. They wouldn’t hear otherwise. Their ideology told them that authority was bad — even if the authority was in the process of saving them from being poisoned. If not for state troopers guarding him, it might have turned out very badly for my father.
Did you ever read that Flannery O’Connor short story “The Enduring Chill”? It’s about an arrogant young intellectual who refuses to listen to his dull, perhaps racist country mother, doing the opposite of what she advises on a matter of drinking raw milk in a dairy (I don’t want to spoil it for you), because he judges her recommendation to be driven by ignorance. It doesn’t end well for him. He got into trouble because he judged everything his mother said through a particular emotional framework. To him, everything was about narrative — and he paid for it.
I worry that conservatives who are wound up about refusing masks and social distancing are going to end up like Asbury drinking the raw milk just to own his mom.
Conservatives who say that institutions have blown their credibility by giving bad advice over the years, and/or being biased to the left, certainly have a point — but not a dispositive one! Arendt said that totalitarian leaders have “natural resentment against everything they cannot understand,” which is a quality we find in society too. This resentment found full expression in post-WWI Germany, where institutions and institutional elites were distrusted, in large part because they had led the nation into the 1914-18 disaster. My concern about conservatives rejecting medical expert advice because of epistemic closure is greater than my concern that medical experts will wreck everything because they had their heads swimming in data, and couldn’t see the real world. Nevertheless, the ideologization of institutional life, including within health and medicine, plays a role here. Both things can be true at the same time, as the reader who wrote the note above realizes.
One of my readers who is a physician just e-mailed to say that he is a veteran of the AIDS crisis. He wonders what HIV research and treatment would have been like had doctors and scientists had to contend with the Internet and social media questioning their every move, especially within a pre-set political framework. That’s a great what-if.
Last word: I am sure that the reader is correct that masks are not just masks now, that they are a condensed symbol of Who We Are, and Who We Are Not. As Rusty Reno said, the world is divided into two kinds of people: People Who Won’t Wear Masks, and Cowards. Some partisan of the other side might say: People Who Wear Masks, and Damned Fools. The thing is, no Irish laborer in 1960s London would have gotten sick or passed disease around if he ate beef on Friday. The virus is a real thing. The truckload of chicken my father condemned and had hauled away over the protests of the hippie mob likely were contaminated, even if the Man said so. And so forth.
UPDATE: A really good reader comment:

I attended an elite public health program for my graduate studies and can confirm that the next generation of public health students (at that level at least) is almost exclusively liberal. I was one of them during my studies and remembered feeling relieved to be studying in a field that was so ‘enlightened’ and devoid of those conservative curmudgeons. There was one girl, though, who was whispered about because she not only was married with kids, but also was rumored to be conservative. I didn’t have many classes with her, but I’m sure she felt like a pariah amongst us. Not due to intentional discrimination, mind you, but it was clear that she was an other.

I remember feeling outraged when the chair of my department had some qualms about hosting an event about the anniversary of Roe v. Wade. To us it felt like a complete betrayal of everything we stood for. How could he not believe in saving women’s lives? Abortion had clearly saved women and improved their lives, so clearly it was a public health victory that must be preserved! The chair was strongly dedicated to child health, which explains his reservations, but that was unacceptable to us. It simply could not compute in our brains that this was a legitimate viewpoint from a public health lens!

Clearly the field of public health desperately needs additional viewpoints, but as your reader noted, it’s going to be a very difficult working environment for any conservative to join. The bubble is real and no one inside seems to realize it nor seem to care if they do. The viewpoint was that if you were smart enough to be there, you had to be a liberal. The entire right was derided and scoffed at, so any idea coming from it was seen as suspect at best or racist, homophobic, etc. at worst.

On a side note, you’ll see what I call ‘public health creep’ everywhere. When housing is public health, racism is public health, education is public health, and more, what really is public health at all? Now, I would NEVER say this publicly for fear of being ostracized from the public health community. And it’s not that I’m saying that these things don’t affect health — very clearly they do. My point is that we’ve lost focus in the field and are funding plenty of studies that are just going to confirm what we already know or, worse, confirm (through bias in design) whatever liberal views of the world currently prevail. Very little that is ‘learned’ is actionable in many branches of the field. It’s wasteful and infuriating and damaging to the field’s reputation so that when you have real crises such as now, we’ve wasted our capital on the wars of identity politics. If public health researchers just preach to the liberal choir, why should we ever expect huge swaths of the country to listen to us now?

From reading your work and doing a lot of personal growth, I’ve become much harsher on my past self and very (quietly) critical of the field. It’s going to take some very brave souls to turn the ship.

Reminds me of a story. Once I had the occasion to have a reunion with a childhood friend. Friend was a doctor. Both of us were married. I had kids; at our reunion, my wife was heavily pregnant with our next. After a cordial lunch, we went to the parking lot of the restaurant, and my old friend, out of nowhere, laid into me about what a horrible person I was to have written pieces (she had googled me) opposing abortion. She spoke to me, an old friend, like I was some sort of monster. She raged about the good of abortion — this, in front of my shocked, very pregnant wife — and about how she had a moral obligation to get me good and told. That was pretty much the end of our friendship. My wife sobbed in the car. She had not imagined that I had friends like that. Neither had I.