Farah Abdessamad writes:

In 1952, the 27-year-old Frantz Fanon had just published his first book, Black Skin, White Masks, his controversial and rejected doctoral thesis on the effects of racism on health. Fanon had been interning at Saint-Alban hospital in southern France when he soon noticed that medical personnel often overlooked and minimised the concern of North African patients. At that time, Morocco, Algeria and Tunisia (where my father was born) were either French colonies or protectorates, and these patients were first-generation migrants, men who had crossed the Mediterranean Sea in the aftermath of the Second World War to rebuild metropolitan France. Life wasn’t easy for them. Most lived in insalubrious working-class estates afforded by their meagre earnings, and occupied the bottom rung of French society. They survived on little more than a deep nostalgia for the home and family they had left behind. And they shared similar symptoms of an unnamed illness. From Fanon’s clinical observations – which would influence his hugely influential book and propel him to join Algeria’s Blida-Joinville psychiatric hospital – he wrote a seminal article exposing a common set of symptoms of what he called the ‘North African syndrome’.

North Africans complained of elusive pain. Their descriptions, according to French doctors, were unreliable. It seemed that they lied about or exaggerated their ailments, becoming nothing more than a medical inconvenience. But Fanon took the time to listen. On traditional grounds, their pain was hardly explicable. They ‘arrive enveloped in vagueness’, Fanon wrote and, apart from rare cases, they presented no physical lesions. It hurt ‘everywhere’ and nowhere specifically. Doctors wanted to diagnose them in order to properly administer medicine, but the patients became irritated by all the questioning because their suffering was right there, almost unbearably self-evident to describe. ‘It hurts’ – but what is the nature of this it?

France in the 1950s stood at a turning point. The Algerian War of Independence exploded in 1954, which Fanon actively supported for the remainder of his brief life, and the French Union (nominally replacing the colonial empire) lost its colonies in Southeast Asia. On the eve of independences and decolonisation, Fanon theorised that the physical pain endured by the North African migrants was an avatar of a deeply rooted alienation, a manifestation of depersonalisation. He analysed their shared complaints of physical suffering as a ‘theory of inhumanity’:

Without a family, without love, without human relations, without communion with the group, the first encounter with himself will occur in a neurotic mode, in a pathological mode; he will feel himself emptied, without life, in a bodily struggle with death, a death on this side of death, a death in life – and what is more pathetic than this man with robust muscles who tells us in his truly broken voice, ‘Doctor, I’m going to die’?

The North African workers struggled to articulate their socioemotional deficit, etched in colonial violence and uprootedness. Fanon recommended collectively working on the ‘meaning of a home’ to address their dispossession and pain. He debunked his peers’ prejudices that often equated these odd afflictions with stupidity or madness. For example, ‘sinistrosis’ – a diagnosis invented at the turn of the 20th century to account for workers’ supposed propensity to exaggerate accidents with a view to claiming compensation – later became associated with North Africans in particular: medical and political concerns converged. But the North Africans who stumbled into Fanon’s hospital weren’t deranged or cunning. They were unwell because adverse conditions in French society had crushed their humanity.

Fanon’s article led me to interrogate why pain afflicted French North Africans more than others, whether this is still the case, and what we can learn from the extent to which their sociocultural conditions play a critical role in shaping and understanding pathologies. I am not a doctor like Fanon; my experience is more subjective than objectively testable. To me, pain is both viscerally personal and universal. It has the potential to make us feel alone in the world, but also to connect with a wider group enduring the same ordeal. [Continue reading…]