I am so at home in Dublin, more than any other city, that I feel it has always been familiar to me. It took me years to see through its soft charm to its bitter prickly kernel - which I quite like too.

Ivan Illich: An Exchange


To the editors, Dublin Review of Books

Dr Seamus O’Mahony’s review of Todd Hartch’s The Prophet of Cuernavaca: Ivan Illich and the Crisis of the West (Dublin Review of Books, July 2017) was of concern to many of Ivan Illich’s friends and associates for the way in which it mixed admiration and invective, amounting at times almost to contempt. On the one hand, Illich was praised as a prophet whose “core arguments” have proven and even “strengthened” themselves over the years; on the other, he was denounced as an “arrogant, petulant, self-regarding humbug”, a “hypocrite”, a crank, and a writer of “impenetrable prose”. I was closely associated with Ivan Illich during the last fifteen years of his life and published two books of interviews with him – Ivan Illich in Conversation and The Rivers North of the Future: The Testaments. I hope you will allow me to correct what I consider to be the most egregious of Dr O’Mahony’s errors and casual slurs.

I will restrict myself to three of these: first Illich’s work after Medical Nemesis is treated in a cursory, patronising and dismissive way. For example, Illich’s outstanding contribution to the history of reading and writing, In the Vineyard of the Text, is described as the outworking of an “obscure pet enthusiasm”. Second, Illich’s views are misrepresented to the point of complete caricature. Typical is the reduction of Illich’s argument in his book Gender to the view “women had been better off in traditional societies in which they devoted themselves to their families”. Third, Illich is incorrectly shown as a fundamentalist who died of his own “bloody-mindedness” because he “couldn’t bear to swallow his pride” and allow the facial tumour from which he suffered to be treated by “a profession he despised”. This is completely fanciful. Illich did seek medical treatment in other cases and refused it in this case for carefully considered reasons. These reasons are discussed in the introduction to my The Rivers North of the Future. Dr.O’Mahony is similarly mistaken, and shows himself a careless reader of Medical Nemesis, in his claim that Illich rejected “safe and effective surgery …asepsis …antibiotics … [and] painless dentistry.” Illich did not reject modern medicine altogether, as Dr O’Mahony here implies, though he certainly advocated more sparing use of its techniques and a much simplified tool-kit.

Todd Hartch, in the book Dr O’Mahony is reviewing, is also ambivalent about Illich, calling him a “prophet”, with no obvious irony, but then condemning him for wanton disobedience to the church, as well as for “a lack of lucidity” which allegedly caused even his friends to misunderstand him. Would that Dr O’Mahony had analysed this ambivalence rather than just reproducing it. I am delighted that a prominent Irish physician, writing in a respected journal of Irish opinion, has recognised Illich’s prescience about medicine, but it’s bittersweet to find this praise alloyed and undercut by so much that is unfounded, uninformed or just plain insulting.

David Cayley, Toronto

Seamus O’Mahony replies

I read David Cayley’s comments with interest and bewilderment. I wrote the essay on Illich mainly because I felt he was an important thinker whose reputation and fame had declined since the 1970s, and I hoped to rekindle interest in his life and work. The thesis on medicine and society which he set forth over forty years ago in Medical Nemesis is more relevant than ever. The main theme of my essay is that Illich was a major intellectual figure who had something valuable to say about modernity. No good deed, as they say, goes unpunished. Although the essay is essentially in praise of the man (read the final paragraph), I tempered this praise with some mention of his failings. That he was very often arrogant and petulant is well-documented in Todd Hartch’s book, and elsewhere. He was indeed at times a hypocrite; even friends such as Jerry Brown admitted this. An obvious example is the fact that he globe-trotted by jet despite his pronouncements on the evils of travel. His prose was often impenetrable, as a re-reading of Medical Nemesis confirms.

I will respond to three specific points raised by David Cayley: (1) Illich’s later books, such as In the Vineyard of the Text (“a history of the relationship between the axioms of conceptual space and social reality”),were indeed, obscure, in that they did not attract a wide general readership, and were of interest mainly to academics. (2) I did not specifically critique his book Gender in my essay; I simply mentioned Todd Hartch’s account of Illich upsetting feminists. (3) Illich rejected conventional medical treatment for the tumour which eventually killed him. This is undisputed. That he accessed conventional medical treatment for other ailments is neither here nor there.

David Cayley accuses me of a failure to tackle Todd Hartch on his “ambivalence” about Illich. That is because, as Cayley correctly points out, I share this ambivalence, and, in my essay, explored the reasons for this in some detail. By the way, there is nothing inconsistent in Hartch’s view that Illich was both a prophet and wantonly disobedient to the hierarchy of the Catholic church.

Illich’s force of personality was such that he attracted disciples as much as friends, and much of the material written about him since his death by members of his inner circle has a hagiographic flavour. Illich was a singular man, touched with genius, but he was not a saint.