"The following piece is written by Miami IWW member, Scott Nikolas Nappalos. This
particular article is undeniably keen and highlights the setbacks of the healthcare
system. It also explains how healthcare militants should go further than just changing the
health system, but to also develop healthcare that enhances it?s ethics and values.
Therefore, we recommend to read more below and hope that you will enjoy this piece." ----
On the bed lies a body. At one time it could have been 5 feet or so, but has withered to a
size barely measurable in the geometry of twisting limbs locked in rigid angles now
permanently affixed to the chest which pumps in hissing heaves like a steam engine whose
fuel is a beige milk churning into her belly from a crude plastic machine.
A naked woman walks down the hall at 2am screaming as though someone is murdering her,
covered in bruises with burnt lips and dark rivers scarred into her arms; she won?t stop
crying until the narcotics flow into her IV and she is quiet for 30 minutes, when we?re lucky.
Looking into her eyes heavy beads like sap become fat until they soil her cheeks and burst
on the table of plastic with shapes printed by a machine to look like the lines that form
on wood from years of growth within a tree. I wonder what her life will be like with a
second child, for the children, and for the scared parents of only 16 years. I follow my
mind?s path to her job as a waitress and the children at her grandparents, the music she
listens to, her boyfriend?s adolescent tattoos fading, and how they will speak to these
small creatures. I ask the same questions when I help with an abortion, and imagine the
pains lifted and sometimes imparted. I can?t help but ask myself these questions, as
though I was the one with the children sleeping.
Healthcare does not make me think of death, but of life and how we live. Most of what is
written about health is about healthcare and all the problems with our particular system:
its cost, the poor outcomes, access to resources, hostile and alienating treatment, etc.
That is natural in a way. We are confronted with things we?d rather not face most when our
lives come apart; when we are in the ER holding a compress to a bleeding extremity,
weighing out what will happen if there is or isn?t a fetus stewing inside in amniotic
juices, when our loved ones are pale and absent, or when doctors tell us amidst hurried
footsteps that our lives will never be the same and there?s a pamphlet with cartoon
drawings for what we ought to do and have done unto us. The universal hatred for how our
bodies are treated appears to us a distinctly modern kind of thing. Going to clinics and
hospitals involves giving up a lot of control to a force that we?re constantly reminded is
dangerous, greedy, and hostile in spite of millions of truly dedicated and often
altruistic healthcare workers within. The domination we experience through health care is
necessary perhaps but manifestly unjust and somehow avoidable; if only we knew how. We
take it like bitter medicine but not without scorning the drug maker.
The political prescription of most stripes centers on how we organize, distribute, and
access healthcare. Here is a weird point of convergence of the political left: that the
solutions to our health lie roughly in equal access to quality health resources. You know
something is strange when a motley crew like anarchists, socialists, and most liberals
line up on a great deal. There are tactical and strategic differences over profit, how we
distribute, pay for, and administer healthcare. To be sure universal free healthcare would
be a serious improvement for humanity. Whatever adjustments would have to be made, at the
end of the day better access and more democratic administration would bring real joys and
capacities to people who might otherwise suffer alone for years. The burden of caring for
the ill is massive and literally is ruinous, and nothing to baulk at.
Still there is something backwards in looking at the problem this way. Healthcare is only
a tiny fraction of what health is. Healthcare is what happens when your body?s problems
become strong enough to motivate you to find someone to help when you couldn?t solve it on
your own. In an ideal world that includes education and prevention to anticipate those
problems. Progressive ideas of health often include thinking about the environment in
helping sustain health and avoid illness and thinking holistically about health throughout
life. Such health programs center on the administration and distribution of existing
healthcare largely to minimize the impact of illness and improve health across the world.
Despite a lot of work to the contrary thinking of health as the absence of illness still
pervades, especially political thinkers. Appeals to holistic health aside, all the
solutions line up around resources and their management. Adding some alternative health
practices adds more resources to the mix, but doesn?t dig deeper into what we are trying
to do with those resources.
If not that then what though? Ultimately we have to start by asking what health is. Health
is something like a human potency or our powers and abilities that make a life worth
living possible. This kind of definition is inherently about values, what we want and
aspire to. Health is not neutral, but is wrapped up in how we think about life, living
well, and the social fabric of being human.
The problem with a political approach to health is that a reorganization of healthcare
does not get at health at all. Dissecting mundane experiences in health facilities opens
this up easily. Most of the major decisions about how we live are made for us without
input. For instance it is taken for granted that the best solution is to use medicine to
extend life in such a way where elderly people continue to live, however are fully
dependent on the care of largely strangers as most work too much to care for their loved
ones. Is it best to lengthen life span (and indefinitely?) when our elderly are warehoused
often in total sensory deprivation and isolation?
Or consider cancer treatments like expensive chemotherapy which can be truly life saving
for some. Is improving access to chemotherapy the answer for patients with cancer? What of
cancers themselves proliferating? The problem with thinking of health only in terms of how
we organize the industry of health is that as people we come at it differently. We
encounter our own health through our living such as when chemotherapy forces many patients
to chose not how they want to access those resources, but how they want to live each day
balancing different side effects of disease versus those of the treatments, or more
importantly what it means to live at all. The relative growth of cancer is a controversial
subject in general, but it is clear that there are strong aspects of society producing
environmental conditions that facilitate cancer proliferating. Those choices are about how
society is built and how we live, and we build healthcare in its image.
What are our goals then with these treatments and tools we have? Is it to allow
debilitated patients to continue living entombed in their bodies for decades completely
isolated from the outside world? How about the millions of children born into truly
horrific circumstances of daily existence, what are the health implications of that? And
what of improving health to allow us to work endlessly at meaningless jobs that make
people miserable?
If health is about how to live, i.e. an ethical question, then the beginning to solving
the problem with healthcare isn?t a political reform or revolution at the level of
resources, but rather starts at what we want to do with our time on earth. Whatever
healthcare exists can only serve our ends if its about our ends, our values and goals.
Health is an activity, something we sustain, create, and reproduce through action guided
by our vision. It augments the broader social relationships and action that constitute our
living. Health is an embodiment of the desires, powers, and will that we sustain and is
merely supported by healthcare, and reflective of the society we live in and its values.
This way of living and these societies we find ourselves in corrupt our health even before
our healthcare. We need a revolution of values before we can uproot the illness that
creates all the barbarity anyone with an open heart sees in the clinics, hospitals, and
health centers of our times. Struggling to expand our living helps expose the way in which
how we live today and our healthcare are strangling our potential, and the vast horizon of
humanity open to us should we take another path.
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» IWW,Healthcare is Only a Tiny Part of Health By Scott Nikolas Nappalos