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Health and Class


This is chapter eleven of the book RPS/2044: An Oral History of the next American Revolution. RPS/2044 has its own book page, with front matter, reviews, essays, interviews, testimonials and place for user interaction with the interviewees. It is available via Amazon. In its eleventh chapter Barbara Bethune and Mark Feynman discuss 
class relations and health.

Barbara Bethune and Mark Feynman discuss the emergence 
of the health front of RPS and its relevance for RPS views on class.

Barbara Bethune, born in 1992, you became a medical doctor and from the start questioned your profession. Your early RPS involvement solidified your purpose to revolutionize health care and you later became RPS shadow Secretary of Health. Can you tell us your path to becoming a doctor, and then into radicalism and your medical activist involvements immediately after the convention.

I became a doctor feeling I could be good at it. I developed the ambition partly from admiring doctors in the family and partly from the example of a doctor who treated me at a young age. Frustrations surfaced in college when my medical training ignored social causes and prevention. The anti-health aspects of an internship at a major Chicago hospital sealed my radicalization.

Being an intern did it?

Intern training pressured us to jump ridiculous hurdles and passively accept that we shouldn’t fight the system. We could whine to friends away from the job, but we shouldn’t challenge employers. Our silence let us graduate, but also prepared us to impose similar insanity on those who came after us. Our silence implied internship rituals had merit. We didn’t become robots. We still cared about patients. We still had souls – most of us, anyhow. The problem was we were corralled by hospital roles that undercut our intentions.

Why would anyone put up with it?

To become a doctor we had to fulfill academic rituals and defend doctors’ rights and privileges. We worked long hours for large incomes and great status, and we never thought to ourselves, this is wrong. To think such thoughts could lead to resisting our roles, which could lead us out of the profession.

Accept impositions. Respect hierarchy. Enjoy income. Bludgeon those below. Teach successors to do likewise. Then do your best for your patients.

From my family, I was familiar with dissidence, so I questioned limits. I asked why interns work for thirty or forty consecutive hours and then treat patients. It didn’t provide good health care. Why accept long work hours? Why not have more doctors so each can work fewer hours?

So what was internship about?

The more I considered that, the more I felt internship mainly limited the number of doctors to keep up doctors’ incomes. To join the fraternity of doctors, we had to display fealty consistent with what our future roles required. We had to comply, or quit.

I began to see interning as sophisticated hazing and to test that impression I visited a military boot camp and watched new soldiers undergo training. Clearly they weren’t only learning to shoot or to work together or even to be prepared for dangerous situations. Boot camp had elements of all that, just as interning had elements of medical learning, but boot camp mainly removed residual social and moral inclinations. It produced soldiers ready, willing, and even eager to kill on command. Boot camp molded recruits to passively follow orders. It educated recruits to ask no questions. It graduated soldiers no longer able to resist orders.

Military boot camp was a cauldron of personal reconstruction designed to produce soldiers who would blindly obey orders and do extreme damage without raising the slightest question. Graduates of military boot camp would generally accept and even celebrate having no say in policies and actions.

And you felt that that was true of being an intern?

I did. After viewing the military dynamic, I looked back at interning and I saw that it sought to create doctors who would defend their huge salaries and prerogatives against any challenge regardless of the health care implications for patients and society.

Regardless? Surely that is too strong a word…

Is it? Interning created doctors who would abet pharmaceutical profit seeking at the expense of engendering opioid addictions and economic rip off. It created doctors who would denigrate nurses, keeping them excluded from decisions and blocked from activities doctors preferred to do even at the expense of patient well being. It created doctors who would defend incredibly inflated incomes by keeping down the number of doctors via exclusionary medical school practices.

Medical interning didn’t mainly advance health, knowledge, or preparedness, much less compassion. It conveyed medical knowledge despite itself. I became curious about other professions so I looked and found similar dynamics for lawyers and other professions as well. Training professionals harbored a giant Catch 22. It gave diverse skills, knowledge, and confidence to a set of people even as it ensured that they wouldn’t use those gains on behalf of society, but only on behalf of themselves and those above.

Becoming a doctor entailed navigating pressure, frustration, and anger, and provoked various reactions. Mostly, at least before RPS, people would try to do good and be ethical without challenging their role assignments. They believed, with good reason, that challenging their roles would change nothing and lead to personal loss. We would deliver medicine to the sick, if the sick could pay, and if tending to them wouldn’t disrupt hospital or societal hierarchies, but we wouldn’t take on the underlying causes of sickness and we would defend and even exploit existing relations. It wasn’t just doctors bent out of shape by medicine’s pliers, but also nurses, custodians, and all medical workplace employees.

Role structures in hospitals like those in law firms, political parties, churches, and other institutions, induced going along to get along. Overturning roles felt like a naive pipe dream. Complying with one’s role eventually switched from something you reticently did under duress, to being who you were.

Benefiting from a monopoly on empowering work distorts one’s personality, including producing blindness to one’s own culpability. Someone who retains sufficient humanity to resist seems saint-like. The harm done to the personalities, values, material conditions, and social options of those below is massive.

I wanted to keep doing medicine, but I wanted to improve health for all. I felt no allegiance to a domineering class above workers, though I understood the pressures and allures of their situation.

So when I went to the convention it was mostly a “Hail Mary” gesture. I didn’t know if RPS could provide a good path forward, but I would try, and I was glad I did.

Why?

At the convention, I met other doctors, nurses, and medical workers from around the country. I was less different than I had feared. At the convention, we empowered each other by sharing similar stories and desires. We talked about changes we could fight for to benefit patients and ourselves.

The ideas that gained greatest traction were seeking comprehensive single payer health care, fighting pharmaceutical companies misuse of medicines, bringing doctors to poor locales, empowering nurses, changing the income and decision-making structure of the profession, agitating for more responsible food policies, and agitating for more healthful ecological policies and work conditions.

I got active in the two aspects where I thought my contribution might be most helpful – trying to battle the pharmaceutical companies, and challenging the harsh hierarchies of income and influence inside hospitals.

How?

For combating misuse of prescriptions, we aimed direct actions at producers. We rallied and sat-in to reveal how pharmaceutical companies not only vastly over charged, but aggressively over prescribed with massive over advertising. We showed the true costs of production of drugs and the insanely high markups imposed by monopolistic pharmaceutical pricing. We shined a light on prescribing unnecessary surgery. The practices we unearthed were nauseating, but we were even more shocked to discover that most people already knew what we were revealing. It turned out we mainly needed to convince people the grotesque situation wasn’t inevitable.

We brought class action suits against pharmaceutical companies. Young claimants fought misuse of mood altering medications. Elderly claimants fought companies trying to grab all their savings. Those addicted to opioids fought pharmaceutical profit seeking and drug dealing. Everyone fought the misuse of antibiotics that risked birthing super bugs and pandemics – and grotesque pricing policies. We undertook a national boycott of the worst pharmaceutical culprits.

My other focus was challenging elitist dynamics inside hospitals and health care generally. Racism and sexism had been addressed with considerable progress, but class division had never been addressed at all. First, we got people to talk at meetings. Next we sought greater income, more influence, and access to more skills for nurses. For doctors, we challenged their assumed superiority and advanced more equitable values and relations, including supporting nurses and other medical workers as well as the non medical staff. Medicine had become a rapaciously self-seeking luxury trade. We challenged its innards.

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Mark Feynman, born in 1990, you became a nurse. A strong advocate for working class politics, you highlighted the interface between nurses and doctors and between workers and members of the coordinator class. I wonder if you can tell us how you first got involved and about some of your early post convention activities?

I went to the convention as a working class nurse already hostile to profit seeking and corporate hierarchy. I didn’t know if the convention would sincerely address my concerns, much less respect and elevate them.

Nurses were there in force to say we hate bad health care. We should be part of providing better. We should be respected. The ridiculous allotment of power and income to doctors at the expense of nurses, technicians, and people doing other hospital work must stop. At the convention we met, talked, and shared our views. We became confident. We celebrated the emergent program and decided to form Health Care Workers United (HCWU), a movement for better health for all which later became a militant, multi-focus movement to organize medical workplaces and win broader health policy reforms. We investigated and learned about our jobs’ financial logic. We learned health workers’ attitudes toward their conditions. We attracted support and initiated positive campaigns.

What did you feel needed to be done regarding the interface between doctors and nurses?

A doctor discussing viruses or kidneys was typically highly informed. A doctor discussing social programs, or even the nature of the hospital he worked in, was typically incredibly ignorant. After nurses had held some sessions, we invited doctors to come and attend one. It was nurses and doctors from around the country, not nurses and nearby doctors who had direct power over them.

One nurse – me – got up and got things rolling. I said, “We respect the work you do, but we feel you are way overpaid, over protective of yourselves, and bossy toward us.” Tensions rose, but I continued, “What I want to know is do you really think you are doctors and we are nurses because you are superior?” Now there was a lot of noise, not friendly. My hands were shaking, but as I proceeded, my fear morphed into anger and I got a little louder. “Do you really think you deserve more income, more status, more power? Or do you understand that you have those benefits despite there being no valid justification?”

What happened?

Emotional hell broke lose but then sensible discussion began. Do doctors have better income and more power due to some difference in ability to attain knowledge? Due to a gap in effort? Due to monopolizing empowering work?

Do the different tasks we do justify our difference in income and power? Or do our different tasks – and our different circumstances earlier in life – lead to differences and means to attain knowledge, which in turn enforce differences in income and power?

The tension was familiar. What was new was realizing how difficult it would be to overcome. We understood that we had to eliminate this class division not only in hospitals but throughout society. We had to involve current coordinator class members in RPS without their dominating RPS.

Right there, that day, that meeting, many nurses realized that should be our main contribution to RPS. Doctors and coordinator class members typically defended their advantages. They believed they were properly empowered and rewarded. They believed they helped those below. Many even believed those below are dumb, parochial, and should be grateful. They felt that while workers should join a movement for a new society, we should not have any decision making say in it. Overcoming all that was nurses’ special agenda.
I sometimes forget it was that bad…

Yes, but there was more. A parallel obstacle to success was that often we nurses accepted we were incapable of empowering work and deserved less income. Or if we were not submissive, we were so furious we wanted doctors out of RPS. The sentiments were understandable, but counter productive. Even worse, we would get so angry at doctors we would sometimes get baited into rejecting training, knowledge, and skill.

I know this wasn’t entirely new, but were nurses alone in addressing this when RPS was emerging, or had it arisen in other ways and realms as well?

The clash had been around for ages and even named and discussed for decades on the fringe of the left. I think nurses in this issue gained prominence in this issue because while nurses were relegated to working class subordination, our jobs weren’t as successful as most working class jobs at disempowering us. We were subordinated like other workers, but we were less socialized and weakened into accepting our plight.

Nonetheless, as activists we didn’t want to alienate 20% of the population who have critically important knowledge. We didn’t want to antagonize them into militantly supporting the status quo and rejecting change. This meant we often put a lid on our feelings. When some of us got beyond that, our only means for gaining support was through alternative media. But back then alternative media aggressively avoided discussing these issues.

Why?

I had the same question and an analogy helped me understand.. I knew self preservation caused media owners to obstruct serious focus on the structures that elevated owners. I knew the whole ethos and culture of mainstream media vetoed private ownership being a major topic, or even a topic at all. In short, I didn’t expect mainstream media to question private ownership of workplaces.

I knew that within the left, even in our alternative media, worker-coordinator class relations got nearly no attention. By analogy, I realized it was like mainstream media excluding discussion of private ownership. People rarely welcomed criticisms of themselves, particularly when it challenged their wealth, power, and self image. Since left media was typically run by coordinator class members, both by position inside the media and also by prior background, they shut off attention to their situation. However, as RPS took shape, the issue surfaced into steadily greater visibility partly due to initial RPS organizers bringing it forward, but also because the issue had surfaced in the Trump/Clinton campaign a few years before.

Opposition to immigrants and blatant racism churned support for Trump but so did anger at elites for imposing collapsing services while they accumulated uncountable riches. Hypocritical lies from above confronted legitimate desires from below. Elites organized to deflect or crush opposition.

We knew that progressives had for decades won serious gains regarding race, gender, and sexuality. We hadn’t won all we wanted, but we had won quite a lot. We also knew that regarding class we had addressed nothing comparable in scope and complexity to the range of issues that anti racist and anti sexist activists regularly battled over. Why not?

How could we explain substantial working class support for Trump and the ineffectiveness of progressives at enlisting widespread working class activism? What could we do about it?

Trump was a billionaire and didn’t for a second deny it. If a large part of the anger fueling his constituency was about economic impoverishment, why were his working class supporters aggressively wedded to one of capitalism’s main practitioners of impoverishing others and what did this have to do with your antipathy toward doctors?

We needed to understand how Trump’s supporters could be so angry at their personal economic plight – and they were – and at media and government – and they were – and yet be so positive about a bigoted billionaire – which many were. What happened to class consciousness? The answer was that the passionate anger coursing through a good part of Trump’s supporters was, in fact, hostility to a perceived class enemy. But the class enemy was not mainly capitalists.

Most working people never personally encounter a capitalist but routinely encounter doctors, lawyers, accountants, engineers, and others who have highly empowered jobs with associated elevated status and great wealth. Workers daily serve these coordinators, obey them, and get meager but absolutely essential benefits from them, but only by accepting demeaning rules and inflated fees. Coordinators routinely treat us like children. Unsurprisingly, on average we despise coordinators even as we depend on and obey them.
You felt this way yourself?

Yes, absolutely, and I still do. I saw the advantages that coordinator class members enjoyed. I wanted our kids to become doctors, lawyers, or engineers however infrequently it could happen given the hugely different conditions people encounter growing up. We workers tended to despise doctors, lawyers, and engineers, even as we wanted our kids to become them.

When I walk around on the streets, in the mall, going to the doctor, or at work, I don’t encounter capitalists, I encounter coordinator class types who dress and talk differently than I do, enjoy different movies and TV, and expect working class people to move out of their way and to follow their instructions as we go about our demeaning tasks. Workers hate being administered, bossed, rendered powerless, considered inferior and paternalized – but we acclimate to it to get by and then we become what we do.

But how does seeing all that explain Trump, or even more so, leftists’ relative lack of success reaching out to working class constituencies?
Trump’s voters believed Trump was personally friendly and unrelentingly forthright, even though he was a dishonest bully. For workers, Trump didn’t masquerade and exude academic arrogance. He shot straight. He was not a dismissive, coordinator class type – like Clinton – who would pander to workers, talk about workers’ pain, claim to support workers, but who workers could feel didn’t give a damn about working people from the way she walked, the way she talked, and the very air that circulated around her, all of it so different than Trump’s walk, talk, and surrounding air.

And, sad to say, while Trump’s supporters’ perceptions of him were horrendously misplaced, Trump’s supporters’ antipathy for the managers, doctors, lawyers, engineers, and accountants who earn many times what workers earn and who treat workers like children was often fully warranted.

While working class hostility to what they called political correctness, was undeniably sometimes racist or sexist, it was nearly always hostile to those who used rules, fancy manners, and obscure language to lord over us, relegate, and degrade us.

Some of us thought about the 2016 election before the vote, and decided that if Sanders ran against Trump, he would appeal directly to Trump’s voters, and have answers that Trump’s supporters would want to hear. When Sanders won, in that scenario, Trump’s supporters would have wound up supporting or at least respecting and liking him. Their class consciousness would still be alive, but their hope would be aroused as well, and they would be moving toward opposing injustices and seeking solutions rather than scapegoating other victims.

In contrast, Clinton and a good part of the population were oil and water. Unless Clinton worked a near miracle on her substance and style, we thought that working class voters would hear nothing she said even if she tried to communicate with them. And that was the best case. We worried that if Clinton won – and in the nightmarish horror show we faced, we had to hope that she would indeed win – while her victory would have kept Trump from power and kept the right wing machine from dominating social life, and white nationalist fascism from gaining government support, Trump’s supporters would feel even more angry and more ready to fight than earlier. They would have been ignored yet again. And so the phenomena of right wing populism that was trending toward fascism would not have been beaten back forever, but only stalled. The point is, our thinking was already orienting us to paying serious attention to working class / coordinator class relations.

Even more relevant to what followed, why didn’t the far more accurate answers that left commentators had long given about the state of white working class lives resonate more with workers than did Trump, a billionaire owner who in fact treated workers with contempt? How could it be that decades of organizing had left so many working class men and women susceptible to this narcissistic reactionary? We knew the issue was not mainly the last six months or year. It was the last fifty years. And during that span, we realized that Democrats, and even our progressive movements, had often come across as rooted in coordinator class connections, assumptions, and values, and not as worker aligned, worker identified, or worker led. We realized our movements had often had manners, style, tone, taste, vocabulary and even policy priorities dismissive of working people. And we realized this was apparent to many workers even when some electoral candidate or anti-nuke organizer or campus radical or mindless ideologue said screw the 1% and champion workers – because their other words, phrasing, and style said I am not one of you.

We realized that leftists talked a lot about owners and profit seeking but showed no interest in changing the relation between their own class, or class to be, and the working class. We realized we didn’t listen to workers with real empathy and understanding, so of course they were hostile back.

What made it even more remarkable, was that if activists had taken their ability to see the interpersonal elitism, collective cultural denigration, material inequality, and decision-making exclusion typical of race and gender hierarchies, and transferred that ability to examining the relations of coordinator/worker hierarchy, the issues would have been addressed. But activists didn’t make the connection. We had the tools to see, but not the will to see.

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Barbara, as a doctor, how did you feel about nurses, then, and later?

Then, I was disdainful and dismissive. I paid lip service to equity and even tried to support nurses, but ultimately thought of them as wannabe doctors who couldn’t make the grade. It is embarrassing to admit, but I said I had friends who were nurses, not unlike during Jim Crow racism white folks said they had black friends. But at bottom, I thought nurses fit their position. Nurses were lucky that folks like me designed for them, administered them, and cared for them.

At the convention, I had a hard time even hearing Mark’s message. It was incredible how many notions it challenged and how radicalizing the ensuing insights were. For example, seeing my relation to nurses revealed the gigantic volume of talents and skills stifled to sustain existing hierarchies. I saw the impact of my socialization and work on who I was. The way I finally understood was by seeing that with racism white people had all kinds of advantages in income, wealth, upbringing, and education. They thought they deserved their advantages. But they thought blacks and Latinos did not. Whites were worthy. Blacks and browns were not. I realized that there was very little difference between that and what nurses were saying about my attitudes toward them.

Dominant groups maintain their advantages and convince themselves those advantages are warranted by denigrating subordinate groups. I did it to nurses. That was a shocking revelation for me, and it changed me. I began to think that if society didn’t squash desires, everyone could do empowering, uplifting things. I realized that most nurses could be doctors, and if being a doctor didn’t appeal to some, then those could do other empowering things. I realized it was disgusting for society to have relatively few people do all the empowering tasks and use their empowerment to aggrandize themselves.

It may seem minor, but I remember that at about that time someone played, in a musical moment, John Lennon singing “Working Class Hero.” I was visiting her house, and she put it on. I listened, and for me, there it was. I literally wept listening to Lennon sing, “As soon as your born they make you feel small, By giving you no time instead of it all, Till the pain is so big you feel nothing at all.”

You cried?

I was overwhelmed realizing I was part of doing that to people.

How did the realization affect your views on economics more broadly?

I had heard RPS economic ideas earlier and scoffed at them as ridiculous. Balanced job complexes, income for duration, intensity, and onerousness of work, self management? Come on. Get serious. It is pie in the sky gibberish. Nonsense on stilts. Stupidity on steroids. I wanted an end to profit seeking and the economy being organized for what was then called the 1 percent, but I saw the alternative as people like me taking over. Let’s remove owners, but let’s leave rote workers obeying people like me because that was where they belonged.
I remember a moment in the first convention after the meeting with nurses that had so challenged me. There was a talk about RPS-type economics and after it ended, I walked up to the speaker, and said, “I am sorry.” Not knowing what I was talking about, she asked, “Why?”
I answered, “For years I have dismissed your kind of economic vision as silly and impossible. I didn’t think about it. I didn’t evaluate it. I just dismissed it without engaging it. I now realize I did that because of my own class interests and the biases they gave me. I apologize for that.”

The speaker told me she had never heard anyone acknowledge that so directly before, and thanked me for doing so. She said we are all twisted and fed by our upbringings, schooling, and social roles, and having been subjected to all that it was no sin to have imbibed elitist beliefs. It was only a sin to cling to such beliefs after we understood them. So I stopped clinging, and in time I also let the guilt go.

It is a bit of an aside but I have heard you have a kind of rare disability and I wonder if you mind if I ask what it is, and whether it has affected your political commitments?

It is a little hard to describe and people often don’t believe it. You see, I have no mind’s eye. I can’t see anything inside my mind – nothing but black. I see with my eyes okay. But I can’t put a number in my head and see it much less put two numbers there, like on a piece of paper, and add them in my mind that way. I can’t see a triangle in outline, much less a blue or a green triangle, much less a scene I have experienced or a memory of a place or person, or anything I might imagine. Just black. Nothing else.

And it isn’t just images I can’t put in my head. I can’t experience an odor in my mind. I can’t hear sounds there. I look at you, I see you. I even recognize you. If you looked different than yesterday, I would know. But if I turn away, I cannot see your face in my mind, much less remember and see it tomorrow or next week or in two or five years. I can see you in person a thousand times, and the same holds true. I can’t describe what you look like based on a retained image.

Similarly, I can listen to music, hear it, recognize it, love it, but I cannot play it back later in my mind. I can sing along, when a song is playing, but I cannot hear it in my mind when it isn’t playing. I can recognize familiar people, but I cannot see them in my mind. This has lots of effects, crippling memory, and so on.

But the thing that was to me most striking was that I didn’t know that I was different until I was about forty. I think about 1 percent are as I am, maybe less. I can’t explain and I don’t even know the different ways that I do things without a mind’s eye that you do with your mind’s eye. Once I became aware of the situation, I spent some time asking folks what they could do, to get a feel for what I couldn’t do, and then I realized something amazing, at least to me.

I had deluded myself for decades. That is, if you look at TV and movies, read fiction, pay attention to sports, and so on, there are countless indicators that people use a mind’s eye. Yet I was oblivious to all that. A deep desire to be normal and certainly not markedly different caused me to ignore the signals. I could ignore and still manage well, but I was clearly censoring my perceptions to maintain my self image as being like everyone else.

I learned from that the incredible power of unperceived agendas to bend thought and perception. Here was this major truth about myself that I had shut out. Seeing this made me more tolerant of the phenomenon of self delusion for reasons of self image or ideology.

I also learned, or wondered, what might be the range of attributes people have? I mean here was a really large difference among people, and it was for a very long time not even known to exist, not named, not perceived, even by those who had it. So, how many other big qualitative differences exist in the mental apparatuses that people have? It seemed to me, where there is one such difference, there are probably many more, and I don’t know what to make of that observation, even now.

Barbara, I have been asking folks if they could tell us an event or campaign that particularly moved them personally, during the emergence of RPS…

You might think it would be something in the inspiring pharmaceuticals protests or the hospital occupations. And of course those, and many other health-related events and campaigns did powerfully affect me. But I have long been a fan of movies so I have to admit attending the movie Next American Revolution and then later enjoying the famous Oscar presentation and especially the wonderful Hollywood Strikes left me incredibly inspired.

I think it was partly admiration and my interest in all things films, but it was also the incredible class dimensions of it, including addressing matters of coordinator/worker division and job definition. I don’t think it was a coincidence that the Hospital Renovations Movement came just a couple of years after the Hollywood Strikes. I suspect I wasn’t the only medical person dramatically moved.

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Mark, health care is partially about what goes on in hospitals, but it’s also about the companies that provide medicine, and about how the rest of society produces health or illness. What were some of the early inclinations about each?

The class revelation, and, of course, insights about race and gender, all played a big role. You couldn’t be in a hospital and daily see the horrendous denial and deprivation and not either insulate yourself from feeling anything much – which was the accepted approach as a way to try to function – or feel outraged and then move on to trying to change things.

After all, how often can you see the effects of carcinogenic pollution, monopoly-priced care, warranted hostility toward paternalistic, arrogant authorities, bullet wounds, overdoses, obesity, unemployment, escalating food costs, rampant addictions and diseases spread by profit gouging pharmaceutical policies, misuse of drugs for the mind and overuse of antibiotics, and not lose focus and plunge into depression or become activist – unless you blocked yourself from feeling.

I once went to India for a conference. I was in Mumbai traveling with a well known Indian revolutionary. We were driving and beggars were coming into the street at every stoplight seeking help. They were talented at their calling and would routinely send the worst off among them – or the one who looked worst off, at any rate – to accost the foreigner, which was me. As we travelled through the city, I got more and more distressed, but my host carried on as if nothing was wrong. I finally asked how she could stand it. She told me she had to become blind to it. She had to tune it out. And I realized she did have to do that or the pain of it all would immobilize her. But of course most who took that route developed a creeping coldness of the spirit and soul. Cultivating an ability to look away typically congealed into dispassionate anti-sociality. My activist escort was an exception, but her traveling a better path didn’t negate the observation.

Another time I was talking with a prominent activist from the New Left era who talked about how in subsequent decades he was not able to retain the degree of sensitivity and openness he had felt earlier. He explained that in the Sixties and Seventies he could act, so he tuned in to the reality around him. He turned on to his full sense of human solidarity, and adopted the militant radical path of the day to express his anger. Later he could be a dissident, but to express the outrage he had allowed himself to feel earlier would not resonate or be productive. Not being able to productively express it, he couldn’t let himself feel it. Like the Indian activist, he curbed his empathy.

When I thought about those examples, I realized hospitals bred a similar self censoring in our limited context. I saw that reduced empathy made perfectly good personal sense to daily function, but that writ large it buttressed the system.

Early health movements asked simple questions. Which social policies, behaviors, habits, and requirements caused people to be unhealthy? What changes could improve the situation as well as lay groundwork to go further? The health movement’s growth worked wonders for allowing, admitting, and expressing our feelings.

We initiated various boycotts of unhealthy products and their manufacturers. Then we took up demands about pharmaceutical companies courting doctors to write excessive prescriptions. We took up single payer health care, and we initiated mass campaigns to provide excellent health care in rural and low income areas and in the treatment of children in schools.

The National Nurses March in 2027 was a pivotal turning point. Over 200,000 nurses marched in Chicago and no one knows how many more held strikes and marches around the country. Incredible feelings of empathy, anger, hope, and desire fueled that march. Soon after, we began campaigns in medical schools to revamp curriculum and behaviors, and in hospitals to overthrow the idea of interning as a kind of boot camp.

Can you tell us of a personally pivotal event?

What comes first to mind isn’t something I talk about much, nor was it particularly pretty. It was 2023 or 2024, sometime around then. I was at work, doing my job, but also at every opportunity talking about politics and RPS, especially with nurses, but also sometimes with doctors, and even patients.

One day I went to lunch and happened to sit with a hospital psychiatrist. We had worked together, often, with no issues between us I was aware of. We got to talking, and he took great offense, feeling my views implied he was insufficiently aware or concerned about the well being of nurses, as well as being classist toward working people generally.

We hadn’t been talking about him, or even such relations in general, but about attitudes to campaigns outside the hospital. I didn’t intentionally push his buttons or even have it in mind, but he took it that way. And, honestly, I wouldn’t be surprised if my tone or facial expressions revealed anger at things he was saying about RPS campaigns, seeing his words as classist, because I am confident I did think just those thoughts, and so it was probably apparent.

At one point he flew out of his seat, leaning on the table to hold himself up while shouting in my face. His nose wasn’t more than five inches from mine. He was livid and I thought he might physically attack me. He went on for a time, making all kinds of claims about me being purely mental, uncaring, manipulative, and controlling, and also about him being a caring person.

Without belaboring, afterwards I thought a lot about it. Partly I thought about how to communicate about issues of coordinator class working class relations without so polarizing folks. But I also wondered how a trained psychiatrist who routinely had to maintain their calm in difficult situations, could get so upset over any affront at all, much less a pretty indirect one.

What I took from it was the intense power fueling our being moved to defend our views of ourselves, and the potential of that inclination to subvert our reason and even our history and connections. I also felt this friend would not have been as upset if what I had said was in his own view ridiculous, as compared to it being, as he heard it, regrettably plausible. But this meant a person closer in viewpoint than most others at the time about coordinator class and working class relations, and already at least somewhat able to see and understand the issues, could become even more polarized and hostile than a person whose views were much further away from mine. I suspect a lot of people in RPS could tell similar stories, and I hope we all learned from them. RPS history says we did.

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