Shift work disorder and the normalisation of exhaustion

“Work odd hours or shifts? Sleepy on the Job? You may have excessive sleepiness due to shift work disorder.” So reads the advertisement for the drug Nuvigil. The text headlines a picture of a nurse and a police officer, standing stoically against a depressing, grey background, as the dreary mascots for the pharmaceuticalization of our lives under capitalism.

Nuvigil is the brand name for the drug armodafinil and its supposed use is to “improve wakefulness”. Armodafinil has unknown mechanisms of action, but is a stimulant that produces effects similar to amphetamines. This is, in other words, an advertisement for “trucker’s speed”. And in this sense it is nothing new, just the continuation of a long history of caffeinated office workers, coco-leaf chewing field workers, 7–11 clerks drinking Redbull. But there is a significance in this advertisement, and it has nothing to do with “trucker’s speed” or armodafinil itself, but with the “condition” that its meant to treat.

With a medical name and an FDA approval, shift work disorder represents a legitimization of self-medication for work-related exhaustion. This legitimization has a dual effect. First, it takes self-medication outside of the realm of morality; using a stimulant to stay up at work is no longer a moral failure nor a crime, but a routine treatment for a condition. Secondly, as the self-medicating leaves the moral realm, this legitimization places it in the medical realm, where it becomes symptomatic of a failure of the body, not the soul.

Shift work disorder, according to WebMD, “involves a problem with your body’s 24-hour internal clock, or circadian rhythm….When you work at night and sleep during the day, your body’s internal clock needs to reset to let you sleep during the day”. The medical website locates the “problem” not in the shift of shift work, but in the body of the worker, in their circadian rhythm. Exhaustion ceases to be a reaction to an outside condition, but is internalized into the body of the worker, as a failure of one of its components.

The ultimate effect of this dual process, the de-moralization of self-medication and the internalization of the “problem” into the body of the worker, is the normalization of an anti-human society, and the medicalization of natural bodily reactions to such a society. Society itself is seen a perfect capsule fit for an ideal human, and any failure to fit into it, any exhaustion at work (or dissatisfaction in marriage, or excess energy at school) is a failure of the individual body, to be absolved through remedial medicine. Day and night are stricken down as the rightful dictators of our circadian rhythm, and in their place is installed the capitalist economy, the standard against which we increasingly judge and discipline every facet of our lives.

Silvia Federici, in her Caliban and the Witch, writes of a historical project, undertaken at the beginnings of capitalist development in Europe, to turn the human body into a machine, stripped of its “occult forces”. This project enlisted the philosophical and scientific force of the Enlightenment to map out the body, mechanize its component parts and systems, and explain it as a machine that could and should operate in the industrial factory. The popular understanding of the body as containing magical elements and miraculous powers had to be denied, for these things defy the logic of capital and the imperative of wage work. If the body, and perhaps the whole world, work through unseen forces and unknowable events, it might make sense to skip work on “unlucky” days, and cast spells to find wealth and heal the body. Wide acceptance of this scenario wouldn’t provide the vast, routine-driven work-force that the new industrial economy required. The body had to be disciplined to the clock and the calendar, not the sun and the harvest, the ceremony and the spirits. The body had to be beaten down and molded into a part of the production process itself.

Federici writes, “while the body is the condition of the existence of labor-power, it is also its limit, as the main element of resistance to its expenditure” (p. 141). In other words, the body resists its incorporation into capitalist production through its own exhaustion, it’s own fragile nature. And this is precisely where the medical industry intervenes, and where Nuvigil marks a striking continuation and intensification of a very old capitalist project to discipline the human body.

By taking self-medication out of the moral realm, and normalizing the exhaustion of the body under capitalism, even the body’s physical failures under capitalist work conditions becomes an extension of the productive process; a routine breakdown calculated into the total cost. Self-medication at work used to come in the form of the secret amphetamine, the subversive nap in the cubicle. While these acts were not always, or even often, acts of sabotage or opposition to the capitalist economy and work, they did operate outside of its logic and its view. They could be understood and acted out as techniques of resistance or as shameful moral failures, but always they were autonomous acts that distanced the worker from their wage work, and enforced the recognition of the body’s incompatibility with certain tasks, like working all night. What Nuvigil tells us, however, is that there is no innate incompatibility and there is no need for these autonomous struggles. It tells us that the incompatibility we feel is a simple disorder located in the individual body, not in the structure of work, and it has a simple remedy. It is a medical issue, to be solved pharmeceutically.

Thus the realm of our lives that is directly understood in relation to the capitalist economy increases. We are not beings who become tired when we don’t get enough sleep, but rather we are underactive workers who need a corrective stimulant to adjust to the world. We no longer have to feel shame or exhilaration when we sleep in an extra hour and get to work late, because our problematic lack of “wakefulness” has been solved. We can take Nuvigil, and when the doctor or psychologist asks us, “how are you feeling?” we can now respond confidently, “productive!”.

References:
Federici, S. (2004). Caliban and the witch. New York: Autonomedia.