In May, an exclusive report from the Guardian exposed the painful daily reality of workers at a production plant in Fremont, California. The 15 factory employees interviewed spoke of long, arduous shifts during which injuries were common and safety was largely disregarded in order to meet demanding production quotas. In a blog post from February, one worker at the factory wrote not only of widespread bodily pain resulting from mandatory overtime but also of a culture of silence surrounding it: “Worst of all, I hear coworkers quietly say that they are hurting but they are too afraid to report it for fear of being labeled as a complainer or bad worker by management.”
The factory owner, wary of the optics of the mounting complaints, responded by defending his company’s commitment to safety, citing plans to bring in ergonomic consultants, and, memorably, emphasizing that those in charge are not “just greedy capitalists who decided to skimp on safety in order to have more profits and dividends and that kind of thing.” Most significantly, however, he made a point of highlighting his own brand of ascetic solidarity with his workers: He chose to locate his office in “the most painful part of the factory” and occasionally sleeps on the factory floor in a sleeping bag “to make it the most painful thing possible.”
The factory in question belongs to Tesla. The factory owner is Elon Musk. Musk, the high priest of AI alarmism, has become the most prominent public voice to speak on the future of automated labor. Along with other Silicon Valley elites, Musk joins a number of public figures and scholars who are convinced that artificial intelligence represents the single most urgent existential threat to humankind. He fears a near future in which humans will face a serious risk of mass unemployment at the hands of increasingly capable robots. Addressing a crowd at the World Government Summit in Dubai in 2017, Musk mused: “What to do about mass unemployment? This is going to be a massive social challenge. There will be fewer and fewer jobs that a robot cannot do better [than a human]. These are not things that I wish will happen. These are simply things that I think probably will happen.”
As Peter Frase has argued in Jacobin, implicit in these concerns is an understanding of work as a moral imperative, which obscures the emancipatory potential of automation to allow more free time and necessitate fewer jobs. As he and others have noted, it is significant that when facing the prospect of a working class liberated from drudgery, the popular reaction is one of panic and not celebration. This reaction belies a deep-seated protective instinct toward the most puritanical facets of capitalism: the moral necessity of work and the inherent value of industry. Most urgently, this comes at a time when these very aspects are becoming baked into a definition of human nature increasingly invoked against a dystopic robot future.
But stolen time and wages do not paint a complete picture of physical labor. As Musk’s employees attest, drudgery takes a substantial toll on the body. Capitalism is not only a social, economic, and political order but a medical one as well. Not only do Tesla employees suffer wear and tear on their bones and tissues while their boss promises the obsolescence of their very jobs, but Musk’s own legendary business philosophy reveals a similar faith in the marriage of industry and pain. In his view, inducing pain onto the capitalist’s body brings the boss ontologically closer to the worker, inhabiting her body and sharing in her suffering.
Indeed, Musk has become well known for his self-proclaimed “nano-managing” style, his minimalist aesthetic, and his emphasis on frugality, having once lived on a food budget of one dollar per day in college to prove to himself that he could make it as an entrepreneur. But implicit in this corporate asceticism is an admission that work and pain are inextricably linked, and that when the people on top break their bodies “in solidarity” with those at the bottom, the result is a winning management strategy.
The message is clear: To be a worker is to be in pain; it comes with the territory when one undertakes physical wage labor. Pain is understood by both the capitalist and the general public as an individual issue that each worker must negotiate as part of their own particular economic survival strategy: a transaction in which the health of a part of the body is sacrificed for a wage. The powerful cumulative effect of this is that it is difficult for any one individual (worker or not) to get a grasp of the scale of this problem and, more fundamentally, to understand it as a collective problem at all.
Part of this difficulty can be attributed to the nature of workplace injury. Often the source of suffering lies not in any single event or accident but rather in cumulative stress injuries resulting in chronic pain. (These work wounds are commonly known as Gillette injuries following the 1960 Minnesota Supreme Court case Gillette v. Harold, which ruled that repetitive, minor traumas do constitute workplace injuries.) One study of construction workers in the International Journal of Occupational Safety and Ergonomics found that nearly three-quarters of workers who had chosen not to report a workplace injury described their motives as reliant on the fact that the injuries were “small” and “part of the job.” A study in BMC Musculoskeletal Disorders found that the majority of workers with lower-back pain dealt with their injuries by making informal modifications to their work, but were limited by the extent to which they had control over their hours and working conditions.
Indeed, the workforce as a whole, much like Tesla workers, largely keeps mum in the workplace about pain brought on by physical labor, because of either fear of retribution, belief in the value of resilience, or resignation to it as an inevitable cost of survival under capitalism. Just as Musk’s self-inflicted pain elucidates his belief in work’s marriage to bodily suffering, so too does chronic working pain clarify our understanding of what counts as an epidemic.
Common aches and pains that result from repeated physical actions in the workplace typically occur in the wrist, knee, and neck. The most common by far, however, is lower-back pain, and it is a useful metonym to talk about the rest. Lower-back pain causes more disability worldwide than any other condition, quantified in a unit researchers call disability-adjusted life-years, or DALYs, and is overwhelmingly caused by manual labor. It is the second most burdensome chronic disease in the world, in terms of both human suffering and economic cost.
The data on the prevalence and scale of lower-back pain is striking; it is surprising to see a condition of the body not typically understood as either a disease or a disability at the top of the list in a global epidemiological study. Whether distortions of the flesh are categorized as pathological, as public health crises, as normal, or as desirable is a function of power, not just biology. The materiality of the body cannot be denied, but it is political and economic expediency that determines how, and if, these distortions are worth addressing.
Consider, as a counterexample, the so-called obesity epidemic, the target of a massive public health campaign and the social ill du jour taken up by former First Lady Michelle Obama. Although viewed as a series of personal choices and individual moral failures, public health officials understand obesity to be an epidemic: not simply a series of individual bodies changing in a particular way but a collective pattern, a happening. A public health crisis is not only the allocation of resources to solve (or disappear) a particular pathology but also the elevation of a phenomenon to a problem with a definitive cause worth investigating and fixing.
Not so with lower-back pain. But why is it so difficult to picture the nation’s public health apparatus addressing this problem as a legitimate medical crisis? There are two reasons—one mundane, the other abstract. First, lower-back pain, and chronic pain in the joints and other injuries, are diseases of work, and by extension the working class. They are decidedly unsexy, quotidian, boring to research, and boring to treat. In utilitarian terms of raw alleviation of suffering per dollar, and certainly when contrasted with costly searches for cures, investment in lower-back pain seems to be a public health no-brainer. But medical logics are subordinate to market ones.
Public health campaigns largely serve as engines that drive scientific advancement, produce cheaper and faster technologies, and funnel resources into the corresponding medical field. Larger market and political forces that shape research priorities become policy, and these do not always intersect with the most widespread or urgent medical concerns of the population. Rather, public health campaigns often take their cues from the interplay between technological progress and corporate power.
Consider, for example, the dialysis entitlement written into Medicare in 1971. As health policy researcher Richard Rettig notes, this unusual amendment, essentially guaranteeing almost every American free access to dialysis, occurred during a time of tremendous technological and economic change. Research dollars for kidney disease grew as the National Kidney Foundation became a formidable lobbying power in Washington; nephrology was coming into its own as a distinct medical discipline, and above all dialysis emerged as a symbol of cutting-edge technology:
By this time, the dialysis machine had become a potent symbol of the power of the emerging technology of medical rescue; technology that could make both biologically secure and socially productive life possible. Just as penicillin stood for the progress medical science was making through drugs when it was introduced in the 1940s, so the kidney dialysis machinery had become for the 1970s the epitome of medicine’s ability to turn away death with advanced machines that could substitute for critical biological functions.
This brings us to the second, more theoretical reason for the lack of a public health campaign for lower-back pain. Moving away from seeing a collection of individuals in pain to a biologically connected population with pain requires a major change in thinking. One would have to see the bosses of the world, claiming to suffer in sympathy with their aching workers, as cruel and mocking rather than noble and empathetic.
For a medical condition to receive the full resources of the state it must be understood as a problem, its cause must be desirable to find and, most importantly, the cause, when found, must itself be suitable for eradication.
Capitalism breaks the body of the worker to the benefit of the very state and factory owner that might intervene and facilitate its repair: The tasks that cause this pain produce the wealth that allows the capitalist to spend his time indulging his working-class fantasies, and aching, tired bodies have little time to prioritize challenging an ever more powerful security state and dying empire.
Lower-back pain is the greatest epidemiological contributor not only to corporeal burden but also to lost wages for the worker and profits for the capitalist due to absenteeism or inefficiency on the job. This serves a basic narrative about capitalist production—namely, that it drives innovation by selecting for efficiency.
Implicit in the warnings of Musk and company is that robots are, or soon will be, a more efficient choice than the worker’s fallible mind and breakable body. Back injuries and other undesirable aspects of work are positioned as antithetical to the goals of capitalist production. It follows, then, that it is to the boss’s benefit to address the problem, through ergonomic changes or automation.
Why, then, have we not seen much of either? As the anthropologist David Graeber has argued, the 1960s techno-optimistic promise of the four-hour workday has largely gone unfulfilled. Instead, the largest advances in automation have been in the domains of military, medicine, government, and information technology—the sectors of society that manage bodies and control populations, enhance the capabilities of a growing bureaucratic apparatus, and further consolidate corporate and state power. This suggests that suffering, that drudgery, that the breaking of the body and all its inefficiency, is not opposed to capital but rather an important part of it. Society’s Protestant love affair with the daily grind extends to the permanent marks it leaves on the flesh and the psyche.
As one Tesla worker put it, “everything feels like the future but us.”