The Truth Takes Work
“Not wanting to know means asking for oppression[Timothy Snyder. Our Malady: Lessons in Liberty from a Hospital Diary. New York: Crown, 2020.]” says the historian Timothy Snyder in his analysis of the medical systems in the United States. He continues to say that facts and truth don’t always align with what we feel and believe; but that without the hard work of truth finding there is no freedom. The facts, we will see are horrendous, so devastating that they are almost impossible to face. The refusal to recognize that health care is a human right and that our social and communal arrangements kill more people than any other disease is the most pressing public health plague. “Health is the place that all of the social forces converge to express themselves with the greatest clarity and importance. Health is where everything comes together.”[Reed Tuckson: Battered by the pandemic, communities of color experience sharp drop in life expectancies. PBS News Hour, Feb. 18, 2021.]
Facilitating Emotions
Another fact and truth is that we cannot bypass the emotions and beliefs so fraught and misguided they might be. The objective and subjective realities, scientific knowledge and “conspiracy theories” operate on different planes. We are as handicapped in stepping up to the social and health inequities as in facilitating the beliefs and feelings that originate in our lived experiences of these social circumstances.
We know, there is truth, right and wrong, there are boundaries, differences, people who are better, stronger, more capable, there are losers and winners. We are individuals with different skill sets, characters, and personal histories. Our families share different ancestries, our communities different cultures and values. It appears at times that we live in different worlds, different realities, and on different planets. Our world views are opposite, the chasms between us seem insurmountable; we want to fight for what we believe in, convince others, and win them over to join our causes and worlds.
This makes it difficult for us to listen, step into other people’s moccasins or shoes, see the world from their perspective, find common ground and ways of collaborating across differences. We struggle with building relationships and instead insist on being right, winning and making others lose. Thus, I believe, we need more empathy and what I call communal intelligence.
Our Bodies’ Load
Our bodies are the recipients – some may experience them as being the victims – of the social arrangements and dynamics we live in. Our personal histories, family histories, the community environments we grow up and live in have, as we know, an impact on our bodies and health. Our experiences of abuse, trauma, pain, struggle, or joy, pleasure, and support manifest themselves in our bodies and create health disparities and differences. Our body symptoms and health issues tell their story and shape us in our diversity.
We also experience acceptance and rejection from some of our differences. We know that our body shapes, genders, gender identities, sexual orientations, skin colors fit more or less with dominant culture norms. Dependent on where we fit on these normative scales we will experience in our bodies more or less pain, injuries and diseases. In addition we internalize these norms and add a personal layer of shame, guilt and rejection.
Then, the body manifestations of our diversity, the lived experiences in our bodies through our struggles, pains and illnesses have, as I said, their own stories and they are asking to be told. When unfolded, they express aspects of our own inner diversity. In our identities, the ways we see ourselves and envision our lives we mirror some of the dominant culture norms we have been socialized in. With our personal agendas we become one sided and our bodies responses balance our primary identities and add new possibilities.
Our body symptoms are the embodiments of the world and environments we live in and in some ways also a response to our internalized individual and group identities. With all their complexities and need for social change, they can bring us new insights and solutions. They are the result of social dynamics and offer new openings and doors for more awareness about inner and outer diversity. Our bodies are vessels that carry the individual and social burdens. Paradoxically they help us awaken to our own inner diversity and can bring wholeness. While we are victims of social trauma and illness our symptoms and injuries don’t have to define us. We can re-contextualize them and integrate them into our life stories and use them to learn more about our whole selves. Our symptoms and challenges are problems to be solved and they have stories or messages that are asking for consciousness.
Communities as Harmony
The mind of Man is fram’d even like the breath
And harmony of music. There is a dark
Invisible workmanship that reconciles
Discordant elements, and makes them move
In one society.
The English romantic poet William Wordsworth in his poem from The Prelude has another conversation and claims another idealist truth about Nature’s harmony and her invisible conciliatory workmanship.
While we live in different worlds, have different histories, more or less power and privileges, different genders, sexual orientations, skin colors, ages, and health, we live on the same planet and universe and have a shared basic nature and need for safety to strive and love. While there are genetic differences and inborn traits, no one is born a criminal, liar, or oppressor. While we are unique and special, our neighbor is as unique and special as we are. While we deserve love, health and wellbeing others have the same right.
The body is where we process most of what happens to us and through which we develop maladies as well as resilience, flow, and healing. Trauma and healing express themselves through our individual and communal bodies. They are not just private experiences. The body is the vessel that locks away our stories, good and bad. Resilience and trauma are transmitted over generations through the way our genes manifest themselves in biochemical processes. As doctors, healers and health professionals we owe it to our patients and communities to rethink medicine in terms of individual and community relationships. The purpose of this book is to explore both the wounding and healing of our individual and collective bodies.
Rank Unconsciousness
The biggest issue in health and medicine today is what results from our individual and collective rank unconsciousness; the lack of understanding of how the ways our individual and systemic ranks, powers and privileges impact us and others. Rank unconsciousness is our most serious public health crisis. Rank unconsciousness that takes the shape of racism in its individual and structural manifestations is a death sentence and leads to early deaths. Rank unconsciousness in wealth and resource distribution creates class hierarchies and poverty and causes lost lives. Rank unconsciousness in the balance of geopolitical power leads to destruction and war. Rank unconsciousness in the way we treat our environment results in global warming and real threat to our survival and existence.
The lesson I want us to learn is that each of us as individuals live in the context of a community of other people and the environment and that our individual and systemic relationships have an impact that can foster or destroy people’s health and lives. [Examples of symbiotic relationships in nature will give us answers about collaboration.] So that when, for example, we choose as individuals and communities to overlook power and rank differentials as public health issues and deny health care and health justice as a human right, it is a major ethical and moral issue for us as individuals and a society. I hope this book will help us focus our attention on social and structural dynamics as well as empathy and love, and caring for everyone.
In the following pages I will make the case that there is a malaise of medicine that needs our attention; that the malady of medicine is rooted in the lack of understanding and acknowledgment of the structural dynamics of rank, racism, class and other oppressions; that we deserve to be liberated from the systems of oppression; and that in alignment with Timothy Snyder, to be free we need our health, and for our health we need one another. For this needed collaboration I will draw on Process Work, a set of values, practices and skills that foster multi-level awareness for the benefit of individuals, groups and communities.