If, like me, you follow Ones and Tooze, you will know that Adam recently had heart surgery.
It was a big deal. Luckily, America has some of the best surgeons in the world, to whom only a small handful of Americans have access – but Adam Tooze is one of them. In the episode dedicated to the expensive American healthcare system/Adam’s heart surgery, he talks with great (and deserved) admiration about ‘his team’, the ones who will do the surgery.
We really want these surgeons to be good at what they do. The considerable advances in medicine, medical technologies and surgical techniques is what will (we trust) Save Adam’s life, as indeed they did. We want experts.
But we don’t want them to be dickheads about their expertise – meaning, we’d like them to be ‘our team’ who work with us, acknowledging our agency. And not arrogant, bossy, or taking control of our lives.
See, Adam is not only among America’s privileged (as he acknowledges), but he is also a member of the same professional class as his surgical team. As we all know, this doesn’t guarantee an absence of dickheads.
However, chances are higher that we can see other professionals as members of ‘our team’. By recognizing one another as members of the same class, encountering other members of the PMC helps confirm one’s own values and expertise.
What this also shows is that it is possible to be a niche expert but honour other people’s self-determination, our ability to make choices about our own lives.
Dickheadery is Systemic
Unless you’ve been hiding under a rock you will know that not that long ago, the CEO of UnitedHealthcare was shot and killed. Awful and violent, right. But also. Bullet casings with the words ‘deny’, ‘defend’ and ‘depose’ seem to have captured the ‘structural violence’ that some of the best commentators have argued needs to be understood. That is, there were two kinds of violence at work here. Firstly, someone got shot. And secondly, a kind of violent unfairness is structured into the system.
Australian journalist Rick Morton recently pointed out the ways that this kind of violence is structured through the economy.
Add this to Adam’s analysis of the structural unfairness embedded in the excessively expensive American health system with shameful consequences, including maternal deaths, we can see that systemic dickheadery has consequences that go well beyond hurt feelings to matters of life and death.
The urgency is clear. Daily reports from the USA about suppression of science, health information and government data show that since Trump’s second election, attacks on expertise have escalated beyond rhetoric to slashing universities and the public service – both peoples’ jobs and their ability to do them. This really must be opposed.
However, resentment about meddling experts is real, material and important. The response requires something rather like what I think Keynes was getting at:
If economists could manage to get themselves thought of as competent, humble dentists, that would be splendid. John Maynard Keynes 1936
As we know from Adam Tooze’s surgical team (and everything else…looking at you, climate science) we really need experts. But we also really need them to stop with the Meddling Managerialism, and instead systematize respect. And not just respect for expertise – respect for everyone who needs experts.
And that really is everyone.
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