Ab irato - Guy Debord

Guy Debord on particular medical practices.

Submitted by BNB on July 27, 2009

Ab irato

This Latin expression, which means "in an angry movement,"[1] should return to usage today, when it is hardly possible to write about any subject without being gripped by anger. And yet, among so many other offenses that one could use to "anger the people" (as one said during the French Revolution), perhaps none are more monstrous than the document(s) we reproduce here.

A woman named [Mrs] Antoine had kept from a previous, dissolved marriage a six-year-old daughter who was condemned to a short life by a serious disease. There was no possible intervention, except for simultaneous heart and kidney transplants; maybe even transplanted lungs would be necessary. All the surgeons of France and America, whose taste for experimentation and guinea pigs is well known, refused to undertake such a barbaric and obviously vain intervention. But a British physician was ready to make a name and some money for himself through such a publicity stunt. Mrs Antoine, ensconced in [cadresse dans] the Salon-de-Providence region, raised money through several appeals to public charity in the media. The intervention was made, with the success that one might imagine; on 30 July 1986, Mrs Antoine went on RTL [French radio] to proudly give a suitable victory cry. The radio station in question found her remarks so exemplary and so favorable to the voters' ideas about "medical progress" that it recorded them on tape. One could listen to it by telephoning a certain number.

Ten years ago, comparable infamy was achieved by Ginette Raimbault, "doctor and analyst" (see annex).[2] This couch louse proposed to create a new metier, one at the boundaries of psychoanalysis and cultural promotion:[3] namely, to teach dying children that they are dying and what death is. We note the complementary usefulness of these two operations -- teaching children to die and prolonging their agony -- before returning to Mrs Antoine's revolting remarks.[4]

"I knew that I might lose Aurora. Aurora knew that she might die; she told me so. She said: 'Mommy, I know that I might die.' But she also said, 'I can't suffer anymore and there's no other choice; we must do it.'

"For the first month, there was the possibility of rejection, even . . . uh. . . infection, and if she got through that month, that wasn't bad. And then there was the third month where -- Mr. Yacoub explained it to me -- the third month was also unstable. And is she got through the sixth month, then, on the whole [pour le compte], we'd won.

"She was at her strongest the day she was operated on, this past Wednesday. She came out of surgery at exactly 5:30 pm. At 5:45 pm, she asked me for a Coca Cola. The next day, the little lady no longer needed artificial ventilation. I'd expected a child comatose for eight days. . . . And then, the day after that, she left intensive care, at 2 pm, and this morning she began to take her first steps.

"At the moment of entering the operating room, uh . . . [we were] psychologically well prepared, because I'd gone to the surgical unit with my daughter, whose last image was -- it was of me, and the last words that I said to her -- I said, 'You know, Aurora, that today is it. Mommy can no longer help you. I have helped you with the surgeon; I helped you with the money. Now it must beat you, OK? And so, my dear, go to sleep thinking I have won, I have won, I have won. ' She said to me, 'Mommy, don't worry. I think this will work.'"

Question [from RTL]: She was six and a half?!

"Yes, she was six and a half! (Laughs.) This was at 11:30 am. The operation began at noon. The organ arrived two hours later. Mr Yacoub and his team began the transplant at 2 pm and, at 4:30 pm, the operation was concluded.

"And so, all the parents who have children with problems like this, truly . . . incurable or previously thought to be incurable . . . I ask them to have hope because absolutely extraordinary things are being done; and tell your child, do not hide the truth from them, because they will be much stronger for hearing it."

This Media Mom -- whom we are calling out in the interests of science and who rivals the famous Madame Kaufman, who, with a kind of satisfaction, has been elevated to the spectacular status and almost the [official] profession as "female hostage" -- hides things in the habitual manner of such people, that is, by lying with the most inept clumsiness. Mrs Antoine attributes the responsibility for the decision to poor Aurora (who informed her? who taught her the affected phrased "there is no choice"?). Mothers can now happily declare that, if their daughters survive the month, this "isn't bad." And if they survive six months, then "one" has won! In the style of a sports broadcast, she goes on to present a play-by-play report. It takes more money to make the horses run, but this race ends up with Aurora dying in the arms of her mother. One might admire the delicacy -- quite typical of the era itself and this [particular] social milieu -- of mentioning to a child, and a child in these circumstances, that you found both the money and the butcher, and that this child must in her turn pay her share to her sponsor, who in sum is responsible for the [operation's] impossible success. Here, contrary to an old advertising campaign for an American undertaker, dying isn't enough.[5] Madame Antoine joyously insinuates that her daughter was a kind of gifted child (at six and a half!); as if she was unfortunately in the avant-garde of pathology. And, in her miserable narcissism [son narcissisme de la misere], this winner frankly says that her daughter was happy, because "the last image that she had" before facing her agony was the image, so successful, of her remarkable mother.


It was Prof. Jean Royer, one of the "great patrons" of the Children's Hospital in Paris, who appealed to her in 1965. At the time, Ginette Raimbault, a doctor and analyst, worked at Inserm. As a researcher, she was dedicated to pediatrics and specialized in kidney diseases: one of the most competent in France and perhaps all of Europe, as well.

Particular specialties: death [l'agonie] and bereavement. At a time when dialysis machines were rare and transplants were even rarer, her services to Prof. Royer concerned "suffering" when one is confronted each day with the most unacceptable of injustices: the death of a child. His question to her was, How do those of us who survive live, and is there a way of living better? A way of confronting this failure syndrome, because death is a failure; a means of escaping from the enormous burden of guilt, because death is an error and felt as such by all the people concerned: its the fault of the parents, who feel guilty for not having bestowed "health"; the fault of the doctors, who feel guilty for hardly doing anything; and, finally, the fault of the child, who feels guilty for not being able to live like the others. And for dying.

This compact error, which each person admits [endossait] in their own way, is like a supplementary illness. More confusion in the chaos of life and death. Someone needed to put order into the ambiguity of anguish. Someone had to put into words what is never clearly said. So that each person understands his or her place, their respective roles, in this pathetic game.

Ginette Raimbault's work provided relief. Because she was an analyst, perhaps because she was a woman, surely because she possessed the "virtue of listening," which is one of the most effective human abilities, she [was able to] put herself at the bedsides of others. She especially gave speech to the other that is in each of us, but whose broken speech can only be heard by a psychoanalyst.

Exorcism: she listens to the parents -- the mothers, especially -- who are, she says, "demolished." They are so implicated by the drama that they suffer so as to find their places in it. They look for "reasons" for the illness, a lack, a bad gene. Etiological inquest well known by doctors: all the parents of sick children are in search of pardon. They accuse themselves or they accuse the physician. They come and go in their questions, their grief; they are at once revolted and resigned, lucid and yet silent, desperate and yet ready to deny the undeniable approach of death.

The child who is "in the death situation" tries to tell his parents what he knows. And he knows everything. "Almost all the children," Ginette Raimbault affirms, "have a clear knowledge of their coming death." They feel it be to the logical outcome of their destiny as sick children who are habituated to their own "suffering baggage." Jeannette, who is eleven, says, "They do not say anything, but I know." Camille, who is eight, says "You know, mommy, one day I will go far away and I will no longer see you again."

Ginette Raimbault has an extraordinary clairvoyance that sends our famous question "Must we tell them the truth?" to the warehouse of false problems.

"Which truth?" she asks. The medical truth? The brutal timetables of chances (a month, six months, a year)? The truth is not what one says but what one hears. Something that the other needs to express. That surfaces in a child's dream or nightmare, in the story that the child invents or the landscape that he sketches out in front of us. And so Gabrielle, eleven years old, drew "a stroll in the countryside." A kind of joyous picnic. The people are clear; the colors are vivid. She explains: "Afterwards, we'll have fun, and run, but it is dangerous because of the poles." And she traces out two poles that make a barrier [marked] "Danger of death." She says, "If there are flowers, I'll pick them. If there's bread, I'll give it to the swans. If I can, I'll snack on wild herbs. But there are poles and you can die if you touch them."

This is Gabrielle's truth. It isn't to be commented upon, but accepted. It especially isn't to be "contradicted": the counter-truth is the "fib," the lie, the rejection in anguish with [all] its destructive effects. Because "the greatest shame for the child remains in the fact that no word from the entourage allows him to name the event and inscribe it in his history." Ginette Raimbault doesn't respond to questions. She is not an investigator of fear. Quite simply, when a child tells her "I'm going to die," she never denies it. She asks, "Why, what's happening to you? What makes you say that this morning?" And this gives the child an extraordinary [extravagante] permission: to evoke his own death. By showing him that he has the right to speak of it, that it isn't taboo or shameful. So that he can finally hear what he needs to hear from the other: "I am also preoccupied with your death -- I know that you . . . are afraid . . . you have desires . . . expectations . . . you would like to pursue them . . . you hope to live. . . . What you experience doesn't separate you from me."

Nursery rhymes that go "I stay with you, I am close-by you." Reassurances that "I know, too." Words and attitudes of non-separation, because above all the child desires "to be with." The child says "Don't go, don't leave me, turn yourself towards me so I can see you," because it is he who is leaving. For an unknown solitude. Which he presses, which he learns about, which he conjures away by asking to take his Teddy Bear with him: those whom he loves, close to his face; those whom he doesn't love, on their feet.

Is it enough to be there? Yes, but with honesty. Without seeking to fool the child. Without imposing silence on him for our comfort alone. Raymond, who is seven, says, "Words that remain inside aren't good." If the child doesn't speak about what he knows, this is already solitude for him. "Its not a question of helping them to die," Ginette Raimbault says, "but helping them live until the end." In sum, extend a hand to get them across. . . .

A frail woman [dressed] in white, Ginette Raimbault pursues her task, which, perhaps, is to once again teach people that we can understand death. In a sweet voice, this nice looking woman says, "I can only write my book after . . ." After what? After this truly difficult period in which there was too little hope for the children. Today, thanks to dialysis and transplants, the balance sheet is less desperate. But there remain sick and endangered children everywhere. For them, the hospital remains a place of suffering and separation, which calls for its "humanization." This one is in the right track: today, at Villejuif, there are two part-time analysts in the service of infantile cancerology; one working with Prof Jean Bernard; another working in pediatrics with Prof Alagille at Bicetre.

Ginette Raimbault has formed a team that includes health care personnel. Because the sick person is a whole, that is to say, a person, even when it is a child, and it shouldn't be treated by a physician who only treats the body, on the one hand, and a woman who is tasked with dealing with the anguish of the dying child, on the other hand. Humanization is also a global look at the suffering person [both medically and emotionally].

This task isn't spectacular. A technical invention is not involved. She doesn't recoil from the blows delivered by what we shut away behind the word "illness." Through attentiveness, she joins with those who perhaps will not survive. She shares their solitude; she helps them separate themselves from life and accept [assumer] the event that approaches. With dignity.

An attempt at a better "lived" death? The paradox of these words is only superficial. . . . But this necessitates that we are capable of living better the bereavement that awaits us.

(Written by Guy Debord, but published anonymously in Encyclopedie des Nuisances tome I, fascicule 9, November 1986. Translated by NOT BORED! July 2009.)

[1] In Latin civil law, ab irato means "a man in anger."

[2] It would seem that this annex was attached by Debord himself, and not "as an after-thought" by the editorial board of the Encyclopedie des Nuisances.

[3] The French phrase here, l'animation culturelle, could mean many things, because "animation" signifies activity, life itself, animation, demonstration and promotion. "Cultural promotion" was chosen because of its resonance with the unnamed British physician's publicity stunt [operation publicitaire].

[4] What follows appears to be a written transcript of the RTL interview with Mrs Antoine aired on 30 July 1986.

[5] Presumably the slogan had been "Dying is enough," as in, "You do enough by dying; let us take care of the rest."

[6] Article written by Genevieve Doucet and published in Elle, 16 February 1976.