Most of us probably know this situation. We hurry to catch a bus, but we are too late, too sluggish, and the bus takes off without us. We missed it! Sometimes we blame jammed doors and crowded streets; sometimes we blame the bus driver or other passengers who refused to wait or keep the doors open, even though we were almost there; sometimes we blame ourselves because we might have left earlier; and sometimes, we start wondering about our fitness and why we can’t run that fast anymore. At least that thought comes to my mind occasionally: “Wasn’t there a time when I was kind of faster and didn’t get out of breath that quickly when running for the bus?”
This is probably similar to what Mr. Bergmann thought. He is the protagonist of a health education film called “Health Guide – Movement” [Wegweiser Gesundheit – Bewegung, see sequence below], produced in 1974 by the German Hygiene Museum in Dresden, the major institution for health promotion in the German Democratic Republic. The opening sequence presents Mr. Bergmann as a middle-aged man with a big belly leaving a factory site. Suddenly he starts running, shouting “my bus!” to his colleagues. The camera follows him, showing the jacket stretching around his belly and a face hardly able to hide his exhaustion, while his heavy breathing can be heard. After a short run, it is more than obvious and also told by the voice-over that this body is not fit enough anymore.
East German health education films from the 1960s, 70s, and 80s use the bus scenario over and over again to address questions on physical ability, fitness, responsibility, and self-conduct. But what exactly made this emblematic practice of modern urban life so interesting and attractive for health policy and filmmakers? Its specific storyline allowed to combine two statements of crucial importance. Firstly, the scenario appeared to be useful to convince the audience that a lack of fitness was a problem. Further details of the problem are revealed when we take a closer look at the bus and where it goes. The bus Mr. Bergmann misses is not the bus in the morning, taking him to work. On the contrary, he misses the bus meant to take him home after work. The film tells us: a lack of fitness cuts into your leisure-time. More than that, being unfit also reduces enjoyment and pleasure that might be experienced in that time, which is more explicitly shown by other films of that kind [i.e. “Hygiene – Fettsucht”, ca. 1965]. Secondly, the bus scenario invites the audience to conclude that the depicted problem is a personal and individual one. Correspondingly, another film showing another version of the bus scenario [“Ist sattsein richtig ernährt?, 1967] presents a lean middle-aged man overtaking a heavy man trying to catch a bus. The lean guy succeeds, but he refuses to keep the door open for the big guy. This lack of solidarity occurs throughout all bus scenes. The movies tell us: Don’t you dare to expect someone to wait for you! It’s your own fault if you are not able to catch the bus! Blame yourself!
Following that line of thought, it is the individual that is held responsible for solving this problem, yet with the help of professional guidance. For the audience, this guidance is provided by the professional filmmakers producing the movies, in the movie itself physicians give advice to both, Mr. Bergmann and the audience. They use heart rate measurement—the film shows Mr. Bergmann on a typical ergometer—to objectify the problem. The electrocardiogram serves as a means to quantify a distinct physical characteristic. Similar to the BMI it works as a biopolitical instrument that produces a specific truth about the body, its functions and abilities. While the camera is showing a pulse monitor, the voice-over tells us: “The heart rate is returning slowly and hesitantly to the initial value of 72 beats per minute. His untrained heart needs almost ten minutes for that. […] The doctor knows cases like that very well. He has prescribed more exercise. Constantly.” Mr. Bergmann follows the advice and by that he proves to be a self-responsible subject. At the end, the film seeks to convince us that his regular running training improved the fitness of his heart. A follow-up examination presents a different and by now ‘normal’ heart rate during exercise. Mr. Bergmann’s face shows a relaxed and happy smile instead of his stressed and anxious facial expression from the film’s beginning.
In the post-war period, the hearts of men—medically speaking: cardiovascular diseases—came to be regarded as a new and urgent political problem of modern industrial societies, both capitalist and socialist. On both sides of the iron curtain huge amounts of resources were employed to meet that historic challenge. Long-term population studies in the United States served as a decisive drive for these efforts. First and foremost the famous heart study in the small city of Framingham/Massachusetts, initiated in 1947 and continuing to this day, discovered, or invented, more and more “risk factors.” Since the 1960s, overweight, greasy food, insufficient physical activity, and smoking were considered the most serious “risk factors,” being responsible for making a cardiovascular disease more likely. The results of the so-called “Framingham heart study” have been widely received internationally. When both German states joined the World Health Organization in 1973, in both West and East Germany the “risk factor”-approach and behavioral prevention had developed into dominant health policy paradigms in terms of cardiovascular diseases.
The new medical knowledge and policy created a wide range of possibilities and challenges for individual self-conduct and self-responsibilization. Still in the 1950s, some epidemiologists thought that the emergence of a cardiovascular disease was biologically foreseen, fateful, and thereby beyond control. Yet the concept of “risk factors” created the possibility to influence and improve the living conditions of the ticker. This newly generated knowledge was popularized—in particular by health education films—in order to empower individuals to take that opportunity and work on their cardiovascular health in their everyday life. Yet the possibility and ability to influence the own “risk factors” also fueled a new obligation. You can do it, so you must do it! And if you ignore the suggestions and instructions and fail to conduct yourself in a rational and responsible way, it is your own fault. Apparently, responsibilization and moralization go hand in hand.
Thinking about health education, “risk factors” and healthy hearts sheds new light on my morning struggle to catch the bus. Failure in that struggle and missing the bus appears as more than the outcome of unlucky coincidences. It seems to indicate that I am not taking proper responsibility for my health and for my life. Missing the bus due to an alleged lack of fitness appears to be a sign of moral failure. That’s why missing the bus is political.