In the Social Clinic, the heart and lungs of Society are auscultated (listened to); Society’s underbelly is palpated; a detailed history is obtained, paying particular attention to patterns; further examination is conducted; diagnosis and treatment are proposed; and plans are made to create greater Social Beauty and to rectify social arrangements that are generating the opposite of Social Beauty.1-5 The goal of the Social Clinician is to restore Social Health, by increasing Social Beauty and decreasing its opposite. But, what, exactly, is Social Beauty, and what is its opposite?
Have You Ever Heard the Phrase “Social Beauty?”
Before sharing thoughts about the meaning of “Social Beauty,” may I ask whether you have ever heard this phrase before, or seen it written anywhere, or recall it being discussed? I had never encountered this phrase until I noticed it in Victor Hugo’s 1862 novel, Les Miserables. To my knowledge, Victor Hugo coined this phrase and is apparently the only person who has ever used it. I have not encountered it in any other novel, or in any philosophical, theological, sociological, geo-political, or economic writings or discussions.
Indeed, whenever I have mentioned this phrase, people have stopped, thought, shown a quizzical-but-interested expression on their face, and said, “I have never heard that phrase; what does it mean?” Even after I share my understanding of the phrase, it typically appears as though the concept of Social Beauty is new to the listener, at least in Western cultures—unless some have simply been using a different phrase for the same concept.
What is Social Beauty?
What, exactly, does the phrase Social Beauty mean? What is the concept of Social Beauty?
Social Beauty refers to social arrangements, including the social activities and the effects associated with those arrangements, that increase expression and practice of the best capacities of our human nature—e.g., our capacities for kindness, empathy, compassion, altruism, creativity, and the arts.6-8 Such social arrangements generate high levels of individual and collective Human Spirit, elevated feelings of gratitude for Life, Nature, and each other, including gratitude for opportunities to contribute to the well-being of others. These arrangements are reflections of a deep love and respect for Humanity and the Earth; and these arrangements beget even deeper and more practiced love and respect. These arrangements and the social activities and effects associated with them, are things of Social Beauty, and they increasingly generate further Social Beauty. They encourage, support, create, and give practice to escalating levels of individual and collective kindness, dignity, grace, calmness, confidence, and competence.
These social arrangements, the social activities associated with them, and the effects generated by them, move our hearts and minds via the senses and emotions, as well as intellectually. Like great music, great visual art, and Nature’s beauty, they deeply touch and stir our humanity. They inspire, motivate, deepen, heal, awaken, empower, and liberate; they up-regulate feelings of gratitude, caring, and love. They increase consciousness, address profound social longings, enhance the meaningfulness of life, provide clarity, enliven imagination and conscience, and give us confidence in ourselves and Humanity. These arrangements and activities teach us what it means to be human; they transform people, individually and collectively, as all increasingly participate in the creation of ever-more Social Beauty.
The Opposite of Social Beauty:
The opposite of Social Beauty are the social arrangements, social activities, and the effects generated by them, that increase expression and practice of the worst capacities of our human nature—e.g., our capacities to be selfish, mean, callous, ungrateful, uncaring, untrusting, and spiteful. The opposite of Social Beauty are mean social arrangements that degrade us, individually and collectively, suppress us, seduce us, exploit us, depress us, discourage us, and crush our souls. These “mean arrangements of man” (as Victor Hugo would call them), and the activities and effects associated with them, represent the opposite of Social Beauty. They are reflections of a lack of deep love and respect for Humanity and the Earth, or at least inadequately practiced love and respect; and they increasingly beget further lack of love and respect. These mean social arrangements are extraordinarily powerful; they have the characteristics of malignancy,9 and as such, they are difficult to disassemble.
The Canadian Network of Public Children’s Hospitals—An Example of Social Beauty:
What are the social arrangements and social activities that represent and create Social Beauty? Among the best examples are arrangements that provide and promote Public Activity.10-12
One of the very best examples of Social Beauty is the arrangement of Public Children’s Hospitals in Canada. This arrangement started with the question, “What do children need?” For example, children need primary care clinics, pediatric sub-specialists, various levels of hospital care, clinical and basic science research, and an educational system to train health care workers and share new knowledge.
The next question was “What is the best way to organize the above needs-meeting effort?” The Canadian answer has been the arrangement of a large collaborative national network of independent-but-closely-linked, geographic/population-based academic pediatric medical centers—consisting of public children’s hospitals affiliated with public medical schools. Canadians recognized that each large metropolitan area needed a medical school and a medical school-affiliated children’s hospital, and it was decided to publicly fund these institutions. In Canada, each children’s hospital is Public and is staffed with sufficient types and numbers of academic pediatricians to meet the needs of the population of children in that particular geographic area, including surrounding rural areas. All of these public children’s hospitals are associated with a public medical school (like the University of Alberta College of Medicine) and are fully funded by the Provincial governments.
Each Children’s Hospital within the Canadian Collaborative National Network of Provincial Public Children’s Hospitals operates according to a cost-based, budget-based, altruistic economic model: There is absolutely no interest in “making money.” That is not the purpose of these hospitals. Their purpose is to meet the needs of children and families in their geographic/population area, not to make a profit. The hospitals are guided by moral incentive, not monetary incentive. Each Children’s Hospital is funded according to an appropriate budget presented by the Children’s Hospital to the Provincial government. The leaders of the Children’s Hospital base the budget on actual appropriate costs, including appropriate salaries for physicians, nurses and other employees who are asked to perform appropriate workloads with appropriate efficiency. The Province trusts that the Hospital leadership is presenting an appropriate budget and is committed to running the Hospital in an appropriately efficient way—neither skimping too much, nor being too extravagant. The definition of “appropriate” is democratically determined, with input from all concerned, including patients/families. The entire network is guided by an altruistic spirit and work ethic, as well as accountability, fairness, and verified trust.
A key to the success of this network is that exemplary “natural leaders” are asked to assume leadership positions. Physicians and administrators who have demonstrated exemplary kindness, compassion, altruism, trustworthiness, fairness, competence, wisdom, and leadership skills are democratically asked to serve as leaders. Accordingly, the provincial governments have developed solid reason to trust the budget requests made by these leaders.
Another key aspect is that the Public Children’s Hospitals within this national network collaborate and coordinate with one another to improve care for children. There is no cut-throat competition or empire-building. The goal is to help each other become better. Duplication of services is minimized. Each children’s hospital shares its expertise and new knowledge with all other children’s hospitals. Regular local, provincial, and national educational conferences are scheduled to share information. There is no such thing as “intellectual property rights.” The academic pediatricians write articles and gladly share their new research insights freely, via medical journals and conferences. They do not sell their knowledge, nor do the recipients buy it. Health care, medical knowledge, and medical expertise are not considered “commodities” for sale, they are considered public property to which the public has a right to free access. Health care is viewed as a Human Right. A physician’s opportunity and ability to serve is considered to be his/her privilege and honor.
This same needs-based, cost-based, budget-based, altruistic, collaborative, appropriate reimbursement economic model has been practiced by academic pediatricians throughout the world for decades—though not necessarily in as pure and excellent a fashion as in Canada. (For example, in the USA there is now a mix of public and private children’s hospitals and, unfortunately, an increasing amount of cut-throat competition, duplication, profit-making, and empire-building has infected institutions, primarily at the administrative level.) Generally, though, academic pediatricians throughout the world have altruistically worked together to raise the level of knowledge and quality of care. International conferences are held for this purpose. International Pediatric medical journals have been developed, through which the world’s pediatricians freely share their knowledge and research. Physicians from Canada interact with children’s hospitals in other countries to mutually share experiences and knowledge and mutually improve each other. There is no such thing as exploiting money-making opportunities in other countries. Canadian Children’s Hospitals, e.g., have absolutely no interest in creating an international empire of children’s hospitals designed to make profits off patients in other countries. Within the international academic pediatrics community there is no counterpart to the transnational corporations, like Exxon, General Electric, Microsoft, Apple, etc.
With the Collaborative Public Children’s Hospital Model there is no need for international “free trade” agreements—because nothing is being traded for profit. Knowledge and expertise are “traded” only in the sense of mutually sharing what is needed for the benefit of Humanity.
A good example of the value, efficiency and beauty of this collaborative public model is the progress made in treating childhood leukemia. In the 1970s pediatric hematologists/oncologists at public children’s hospitals in the USA and Canada pioneered the development of a Multicenter Collaborative Research Effort to advance progress in treating childhood leukemia. Thanks to this altruistic collaborative Public Effort, the mortality rate for Acute Lymphocytic Leukemia (ALL) dropped from 90% in the early 1970s to less than 10% today. The knowledge gained has been freely shared with pediatric hematologists throughout the world. There was no profit motive, profit making, or patent seeking involved. The entire effort was guided by moral incentive. Not only has this collaborative Public Activity been extraordinarily successful, it has been a necessary approach to the problem—i.e. such success probably would not have occurred without this collaborative Public Effort, at least not as quickly and efficiently. For decades, pediatricians in all specialties have, similarly, freely and selflessly collaborated and shared their research and knowledge with other pediatricians, nationally and internationally. The process and the outcomes have been things of Social Beauty.
So, for decades, Academic Pediatricians, particularly in Canada, have demonstrated the feasibility of developing a Collaborative National Network of Public Children’s Hospitals, and a Collaborative International Network of National Public Children’s Hospitals. For decades, Children’s Hospitals throughout the world have been practicing a needs-based, cost-based, appropriate budget-based, altruistic economic model. This model has not simply been developed in theory, it has been actually practiced, and has proven to be of great benefit to the world’s children, at a bargain price for societies. Academic pediatricians, especially in Canada, have already demonstrated the value and beauty of this model. If the USA and other countries were to better emulate the Canadian Network of Provincial Public Children’s Hospitals, a currently good International Collaborative Network of Public Children’s Hospitals could become an even better example of Social Beauty.
Furthermore, the vast majority of Academic Pediatricians have found this Public Children’s Hospital Model to be greatly meaningful, gratifying, and emancipating. They would not wish to have approached their work in any other way. They like the Public Children’s Hospital Model, especially the opportunity and freedom it provides to enjoy expressing their altruistic capacities. Working in a Public Children’s Hospital has provided them with one of the most precious freedoms of all— the freedom to participate in public efforts to genuinely look after others; the freedom to enjoy widespread up-regulated expression of the human capacity for kindness–in oneself and in one’s social milieu. They have treasured this Selfless Freedom. In fact, they have been greatly disturbed by the increasing encroachment of a private corporate business mentality into the administrative workings of pediatric institutions (particularly in the USA). That corporate mentality has been increasingly down-sizing (even punishing) altruism, over-extending physicians in order to improve the “bottom line” and adversely transforming behaviors within our children’s hospitals, particularly at leadership levels. The altruism, moral incentive, and Selfless Freedom of pediatricians have been under assault (at least in the USA), replaced with profit motive and profit seeking—and children are suffering because of this.12
The Network of Public Children’s Hospitals in Canada represents a social arrangement that up-regulates expression of the best capacities of our human nature and, thereby, has represented and generated great Social Beauty. This arrangement, its activities, and its effects have been things of Social Beauty—felt by the entire staff of the hospital, as well as the patients, families, and entire community. This Public Children’s Hospital Model is a prime example of Public Activity and demonstrates that Public Activity is particularly good at generating Social Beauty.
Public Economy—A Potential Example of Social Beauty:
Experience with the Public Children’s Hospital Model suggests that vast Public Activity,10-11 throughout all sectors of society, could lead to vast Social Beauty. The Public Children’s Hospital Model in Canada provides an example of what a General Economy could look like and feel like, if all needed sectors of the general economy were to implement and emulate this Model—i.e. if the general economy were arranged as a Public General Economy.11 In short, a Public General Economy could resemble one giant children’s hospital—regarding philosophy, motivations, behaviors, spirit, over-all organization, and logistics—with all citizens embracing and emulating the altruistic motivations and behaviors exhibited by the pediatricians, nurses, nurses-aides, technicians, janitors, and other hospital workers in an exemplary (Canadian) Public Children’s Hospital. A Public General Economy, based on the principles and behaviors of Public Children’s Hospitals, would be an example of a social arrangement that gives generous expression and authentic practice to the best and most beautiful capacities of our human nature. This, in turn, would generate high levels of individual and collective kindness, empathy, compassion, altruism, creativity, gratitude, spirit, dignity, grace, confidence, and competence within the general society. Such a Public General Economy arrangement, its activities and its effects, would be things of Social Beauty, and would increasingly generate further Social Beauty. (More discussion of Public Economy will occur later.)
Publicly-Supported Dance, Music, the Arts—Examples of Social Beauty:
There are other social arrangements and social activities—besides a network of Public Children’s Hospitals and a Public General Economy—that can up-regulate expression of our best human capacities and, thereby, create and represent Social Beauty—e.g. arrangements that encourage dance, music, the Arts—all of which celebrate life and deepen our appreciation of each other and what it means to be human. When a culture provides abundant opportunity for all to learn, practice, and enjoy dance, music, and the Arts, it can create an abundance of Social Beauty, including pure individual and collective joy. In contrast, diminution of the Arts diminishes Social Beauty and Social Joy.
Nature’s Garden—A Example of Social Beauty:
Among the most important arrangements that up-regulate expression of our best capacities and generate Social Beauty are the arrangements Human Societies make with Nature—-arrangements designed to appreciate, respect, learn from, and protect Nature. In fact, Nature, itself, serves as a model of Social Beauty, as Victor Hugo so wonderfully expressed in his description of Nature’s Garden:
Hugo’s description of Nature’s Garden:
“The trees bent over towards the briers, the briers mounted towards the trees, the shrub had climbed, the branch had bowed, that which runs upon the ground had attempted to find that which blooms in the air, that which floats in the wind had stooped towards that which trails in the moss; trunks, branches, leaves, twigs, tufts, tendrils, shoots, thorns, were mingled, crossed, married, confounded. Vegetation, in a close and strong embrace, had celebrated and accomplished there, under the satisfied eye of the creator, the sacred mystery of its fraternity, symbol of human fraternity. At noon, a thousand white butterflies took refuge in it, and it was a heavenly sight to see this living snow of summer whirling about in flakes in the shade. There, in this gay darkness of verdure, a multitude of innocent voices spoke softly to the soul, and what the warbling had forgotten to say, the humming completed. You felt the sacred intimacy of bird and tree; by day the wings rejoiced the leaves; by night the leaves protected the wings.
Nature, who disavows the Mean Arrangements of Man, always gives her whole self where she gives herself at all, as well in the ant as in the eagle.
Nothing is really small; whoever is open to the deep penetration of nature knows this. All works for all.
A flesh-worm is of account; the small is great, the great is small; all is in equilibrium in necessity; fearful vision for the mind. There are marvelous relations between beings and things; in this inexhaustible whole, from sun to grub, there is no scorn; all need each other.
In the above passage, Hugo describes a healthy ecosystem, which included a healthy social arrangement. The plants, birds, insects, and other non-human life in the garden had developed a kind and wise Social Ecosystem—marvelous interdependent relations between beings and things—that benefitted all. In their garden there was no hierarchy, no upper class or lower class, no rich or poor, no caste system, no cliques, no selfish individualism, no isolation, no predation, no segregation, no tension. In the “inexhaustible whole” of the garden, there was “no scorn.” All worked for all. All needed each other. All embraced, celebrated, and cared for each other, as if they fully understood their interdependence and thirsted for connection. All was in harmony, “in equilibrium, by necessity”—meaning that life in this garden would not have survived, individually or collectively, without the marvelous collaborative relations among its living things. This garden symbolized a healthy Social Ecosystem, a social arrangement maintained by the plants, insects, birds, and other living things in the Garden. It was a thing of Social Beauty—offered for emulation by Mankind.
The Network of Children’s Hospitals in Canada, the Public General Economy that we could create, and Nature’s Garden represent three examples of social arrangements that represent and generate Social Beauty. It is these social arrangements and activities, and the effects they create, that are things of Social Beauty and are meant when we talk about Social Beauty. They serve as models for Social Beauty.
Social Arrangements of Current Western Culture—Beautiful, or Mean?
But, to what extent do we see implementation and emulation of the above models in current Western culture? Do the predominant social arrangements of Western culture represent things of Social Beauty, or do they represent “Mean Arrangement of Man”? Have our current social arrangements—particularly the economic model we have chosen—increased the expression and practice of the best capacities of our Human Nature and generated an abundance of Social Beauty? Have we (in the USA) developed a health care system that emulates the Social Beauty of the Canadian Network of Public Children’s Hospitals? Have we developed a Public Economy? Have we encouraged vast Public Activity, including an abundance of Public-supported Arts? Have we used Nature’s Garden as a model for human social arrangements? Have we developed arrangements that are fully integrated with, and fully respectful of, Nature? Have our social arrangements reflected a deep love and respect for Humanity and the Earth? Or, has Western culture (particularly the economic model it has chosen) created and promoted the opposite of Social Beauty?
It appears that Western culture has created severely damaging and degrading social arrangements, more so than Social Beauty. The social milieu in which most people live exhibits little of the caring characteristics of Nature’s Garden, or the Canadian Network of Public Children’s Hospitals, or a Public Economy. Western cultures have chosen an economic model, capitalism, that is based on, justified by, gives practice to, and rewards the worst capacities of our human nature, instead of our best capacities.9 We have chosen an economic model that reflects little love for or faith in Humanity. Furthermore, it is an economic model that shows little respect for Nature’s ecosystems, is not integrated with Nature’s ecosystems, and wantonly destroys Nature’s ecosystems. Largely because of the economic model that we have allowed to prevail (Capitalism), our social milieu is characterized by hierarchy, selfish individualism, cut-throat competition, predation, exploitation, gross income inequality, injustice, anger, scorn, spite, isolation, tension, anxiety, depression, alienation, loneliness, segregation, meaninglessness, and boredom—with its leadership exhibiting heartlessness, disdain for collaboration, and denial of human interdependence.
Our current social system, which is a direct product of our prevailing economic model, represents a “Mean Arrangement of Man”—certainly not a thing of Social Beauty. Our current social ecosystem looks as plundered and ugly as a clear-cut boreal forest, or the toxic tailings ponds and poisoned aquifer in the Alberta tar sands. For the sake of Nature, and for our own sakes, should we not create a better Arrangement? Have the plants, birds, insects, and other living things in Nature’s Garden been far wiser, kinder, and creative than has Mankind?
The Social Beauty of a Public Economy:
If, as a nation, we were to use Nature’s Garden and the Canadian Network of Public Children’s Hospitals as models for development of healthy human social arrangements and creation of Social Beauty, what might we create? We would start by acknowledging our interdependency—that we all need each other, and that all need to work for all. We would ask, “What are the universal needs; and how can we kindly and collaboratively meet those needs?” We would create an economic model that disavows Mean Arrangements characterized by hierarchy, class, exploitation, supremacy, racism, cut-throat competition, profiteering, scorn, sabotage, violence, predatory debt, isolating individualism, and disregard for the environment. We would choose an economic model that is based on moral incentive (rather than monetary incentive), a positive view of Human Nature (rather than a negative view of Human Nature), and a commitment to altruistically meeting the needs of others—a Public Economy with Vast Public Activity that employs all aptitudes and provides jobs to all who need work. It would be an economic model that up-regulates expression of the best aspects of human nature and down-regulates expression of the worst aspects of our human nature (instead of the other way around, which is the effect of capitalism). It would be led by the most altruistic natural leaders among us, not by the most diabolic, selfish, and sociopathic.
In short, we would create a National Public Economy and vast Public Activity—a Social milieu that resembles one giant comprehensive public children’s hospital whose modestly salaried physicians, nurses, researchers, technicians, janitors, and other employees gladly “give their whole selves” to meet the needs of sick children. It would be a model that provides the most precious freedom of all—the freedom to enjoy widespread up-regulated expression of the human capacity for kindness—up-regulation both in oneself and in the larger society— the freedom that comes from participating in collective public efforts to genuinely look after others. It would be an economic model that is democratically regulated by the creative common sense of Nature’s Garden, as opposed to the “clear cut” mentality of authoritarian, non-democratic timber industrialists. Such an economic model could create a healthy social ecosystem that would be in harmony with all of Nature’s ecosystems and with social ecosystems throughout the world. It would include vast publicly-promoted dance, music, and the Arts.
Each nation on Earth could be encouraged to democratically develop its own unique, creative national public economy. This could result in a Collaborative International Network of Unique, Democratically-Determined, Self-Reliant National Public Economies11—based on the philosophy, behaviors, and success of the Collaborative International Network of Public Children’s Hospitals described earlier.
Development of a Collaborative International Network of National Public Economies (to replace “Global Capitalism”) would be a way to create vast human Social Beauty, globally, to complement and protect the Earth’s natural beauty. “Whoever is open to the deep penetration of Nature knows this.”
Certain social arrangements—such as Nature’s Garden, the Canadian Collaborative Network of Public Children’s Hospitals, and a Collaborative International Network of National Public Economies—and the positive effects of these arrangements, represent things of Social Beauty. Other social arrangements (the Mean Arrangements of Man—e.g. the current prevailing economic model) represent and produce the opposite of Social Beauty. The task of the world’s people is to democratically create and support social arrangements that increase Social Beauty; and to democratically disassemble social arrangements that represent and produce the opposite of Social Beauty. Each nation could do this in their own way, while also collaborating with all other nations.
When the phrase “Social Beauty” (or an adequate substitute) is not part of the vocabulary of a culture, and when even the concept of Social Beauty seems foreign to members of that culture, what does that say about the culture? Why would the concept of Social Beauty not have a prominent place among the core values, goals, and discussions of a culture? Why would a culture not have a phrase like Social Beauty in its lexicon? Does the absence of such a phrase and/or the absence of discussion of the concept mean that the idea of Social Beauty is not important to that culture? Or, does it mean that the idea and the importance of Social Beauty has not occurred to some cultures? Have some cultures purposefully discouraged awareness and discussion of Social Beauty? Or, has the concept of Social Beauty been duly recognized and valued, but simply given another name?
Rob Rennebohm, MD
For additional reading, the following “Notes from the Social Clinic” (NFSC) are available upon request, particularly: 11Public Economy and the Development of a Collaborative International Network of Unique, Democratically-Determined, Self-Reliant, National Public Economies:
1 Welcome to the Social Clinic
2The Themes and Strategy of “Notes from the Social Clinic (NFSC)”
3Lessons from the Medical Clinic
4The Medical Clinic and the Social Clinic
5The Social Clinic Movement
6Human Nature—A Graphic Depiction
7Up-Regulation and Down-Regulation of the Expression of Human Capacities
8The Spectrum of Human Kindness
9Problematic Aspects of Capitalism—Its Malignant Nature
10Create Vast Fields of Public Activity
12Little Economic Story: To What Extent Should Capitalism be Practiced within a Public Economy?