Don’t we know we are mortal? 

Is it possible to write a genealogy of medicine to the modern day? A genealogy of post-structuralism, of the floating signifiers of pure difference, (the test result, the QALY), that make possible the diachronic sequences of symbolic exchange through dia-gnosis or pro-gnosis (?knowing what lies ahead), of Broussais’s ‘normality’ – Canguilhem’s aspirational impossibility, of Kordela’s secular shift of capitalism, and the, ongoing, battle between a specific gaze of certain mortality – and the infinite choice of gazes in a sliding hystericised financialised, compulsively utilitarian market place, and its promissory commodities, and radical uncertainty.  
Medicine functions in a dynamic and non-uniform culture – with resistance, multiple, repetitive, individualised and sometimes social, against corporeal subjectivisation, the strange pairing of capitalist-self entrepreneurial-consumer; labouring as wage labourer, forced to labour because of the original sin of mortal abnormality lurking within to be eradicated at all costs, to create a commodity, of congealed labour, congealed fear, purely to make surplus fear, still in just as much debt as before, to labour again through the consumption of the next dia- or pro- gnosis, and so on, endlessly. This is a labour of alienation, through the self-processing by medical technology, where part of the product to be sold on, not owned by the subject, is the compliance with the prophylactic cure, an element of exchange that creates surplus economic value for a range of merchants, and producers, universities, industry, politics, and medical practice. The subject, of this capitalist power, can resist, turn away, but is always called back, the siren call of the loan sharks, “you’re in trouble, we feel sorry for you, but we can help, just come into our little shop for a chat, … ” – where the loan is the promise of cure, the debt your mortality. The consumer of this loan disappears as a subject in a flux of pure differences exchanged time and time again, under the illusion of immortality. 
It might be possible to describe this as a psychoanalytical Lacanian-Marxist framework for understanding how neoliberalism necessitates population level medical overdiagnosis, and over/under treatment by using innovative prophylactic and predictive genomic technologies to peel back layers of corporeal raw materials and subjects in radical uncertainty and existential fear, torn between embracing an inevitable/certain mortality, by making their mark on their mortal bodies, and the illusion of immortality demanded by darstellung’s promise of surplus (that doesn’t so much forbid mortality as deem it impossible), by accumulating wealth, monuments to the future, predictive test results and their prophylactic consequences. The neocon medical empire demands Darstellung, demands action ‘now’ on an expanding battlefront against the inevitable. Discourses of mortality seem to be non existent until the terminal state has manifested itself in a variety of ways. Only then is mortality discussed as a possibility, in another, sometimes illusory optimistic world, of Ehrenreich’s ‘pink kitsch’. 

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