Monday, November 2, 2009

Witches, Midwives and Nurses

Read online version here

I hope to develop through this blog, a holistic understanding of health, our bodies, labor, gender and disabilities struggles. I feel like this pamphlet is exactly the kind of foundational texts that need to be made more accessible in our time. Non-institutionalized, accessible, community run healthcare is not the terrain of new age-y, white, middle class hippies. It is the terrain of women of color, of class struggle, of gender struggle that had been severely attacked historically. I feel like it's time to reclaim, normalize and integrate it into my life and politics.

Commodified care expresses how caring work (which involves love, support, skilled labor etc) has been turned into capitalist properties for the purpose of $$ and not for the purpose of furthering and expanding humanity. It takes the form of disableism, racism and patriarchy in that some bodies are more commodified than others, both as bodies which are seen as useless and therefore suitable only as OBJECTS that can gain profits, or as bodies that are not flesh and blood, but rather machines that can be sped up endlessly. 

The foundation of commodified care is that it separates our physical bodies from our mental and emotional health. Like so many things, it is a product of extreme rationalism, Enlightenment philosophy gone sour, which institutionalizes the mind-body split. This mind-body split is also expressed in classed, gendered and bodily ways -- the elite, the male and the able-bodied cisgendered male is seen as the pedestal of rationalism while the poor, women and gender non-conforming folks, disabled bodies are lacking and more controlled by our primitive, bodily needs. Fixing is what we need, in bodily and mental forms -- thus invasive medical procedures and indoctrinating education that devalue us in our own eyes. On a more everyday level, it is how at my workplace, CNAs are expected to do the servant-like menial labor, do the daily grooming and dressing, but not be trained in medical skills or be given time/space in our workday to BUILD relationships with our residents. This is not to say that relationships dont form between us and our residents, but that they form because of the resilience of relationships and love, not because they had been accounted for as an integral dimension of the caring work that we do. 

What I am most excited about by this pamphlet is its description of the Popular Health Movement, as opposed to the "Feminist" movement led by white, middle class Victorian ladies. The Popular Health Movement involved the widespread dissemination of knowledge about herbal medicine, preventative care, and expertise about the body and hygiene, as opposed to the elitism and isolation of doctors, the professionalized medical establishment. According to the writers, during the height of the Popular Health Movement in the 1830s and 40s,
"regular," licensed, doctors were attacked as members of the "parasitic, non-producing classes," who survived only because of the upper class' "lurid taste" for calomel and bleeding. Universities (where the elite of the "regular" doctors were trained) were denounced as places where students "learn to look upon labor as servile and demeaning" and to identify with the upper class. Working class radicals rallied to the cause, linking "King-craft, Priest-craft, Lawyer-craft and Doctor-craft" as the four great evils of the time. [1]
The peak of the Popular Health Movement coincided with the beginnings of an organized feminist movement, and the two were so closely linked that it's hard to tell where one began and the other left off. "This crusade for women's health [the Popular Health Movement] was related both in cause and effect to the demand for women's rights in general, and the health and feminist movements become indistinguishable at this point," according to Richard Shryock, the well-known medical historian. The health movement was concerned with women's rights in general, and the women's movement was particularly concerned with health and with women's access to medical training. [2]
It is no surprise that the Popular Health Movement and the organized feminist movement overlapped in such a dynamic way. The way women's bodies have been treated and our rights as women have been so intertwined. Rape is the ultimate expression of this conflation -- the objectification of women's bodies, where women's bodies are seen as male property, overlap with the complete erasure of women's ownership, will and choice over their beings.  F, an inspiring woman in my life, has been applying Marxist theory of Alienated Labor to think about how women have been alienated from our own bodies --- we are taught to look as our bodies through the lens of a patriarchal objectifying society and we work it to survive in this society, not through the vision of our own creative flourishing. Women's bodies and the rest of us have been negated in relationship to one another. Either that, or the other extreme, where we are naturalized and essentialized merely as our bodies with no agency. This is most explicit when women's labor of reproducing society, in the very obvious sense of reproducing the next generation through childbirth, has also become invisible and naturalized, and thus devalued.

The pamphlet alludes to the rambunctiousness, the disorderliness of this Popular Health Movement :  it was messy, it was scathing to the upper class and it was conveyed through the streets, in everyday conversation, gossips and debates, which is all just to say it was popularized. I like that feeling it conveys. That talking about health and bodies does not need specialized, confined, isolated, technical, silent spaces, but take place in the middle of everyday living. I can only imagine people talking about women's health, prevenative medication, in the same way we talk about iphones, facebook or Avatar today. Hella people have the expertise to mess with the intricacies of computers or downloading free movies and songs etc, but aren't professional computer technicians. I have never experienced interacting with healthcare seriously this way where debates are not just popular but also have expertise.

I have always been excited to be a queer nurse (when I finally become one!!) And reading this pamphlet, in emphasizing the roots of nursing in patriarchal, middle-class feminity, helps me understand why. I am sure this is hella romanticized, but being a queer nurse feels to me like crashing a straight, stuffy wedding party everyday, like a Queer Nation action, a kiss-in, like being in a sailor/nurse costume at Halloween...I wanna just be all campy and fuck shit up in that disgusting portrayal of what nurses should be: feminine, upper class, good natural mothers, obedient, nice, good woman, etc. Florence Nightingale sounds like a boring white lady, though also a product of patriarchal society:
Let us look a little more closely at the women who invented nursing, because, in a very real sense, nursing as we know it today is the product of their oppression as upper class Victorian women. Dorothea Dix was an heiress of substantial means. Florence Nightingale and Louisa Schuyler (the moving force behind the creation of America's first Nightingale-style nursing school) were genuine aristocrats. They were refugees from the enforced leisure of Victorian ladyhood. Dix and Nightingale did not begin to carve out their reform careers until they were in their thirties, and faced with the prospect of a long, useless spinsterhood. They focused their energies on the care of the sick because this was a "natural" and acceptable interest for ladies of their class.
I guess that's a legitimate struggle -- to carve a space out in patriarchal society for women who escape/deny marriage. It's like Lu Xun's question to Ibsen and the liberal feminists of the late 19th century: Where does Nora go when she leaves the Doll House? Independent women have to carve some societal role for themselves if they reject the patriarchal wife role, and nursing was that for Ms. Nightingale.

That said, the impacts of this reformist women's movement, that sought to carve out more spaces for rich aristocratic women as opposed to a vision of overturning patriarchal society, had really nasty effects on ALL women, particularly women of color, and poor women!
Nightingale and her immediate disciples left nursing with the indelible stamp of their own class biases. Training emphasized character, not skills. The finished products, the Nightingale nurse, was simply the ideal Lady, transplanted from home to the hospital, and absolved of reproductive responsibilities. To the doctor, she brought the wifely virtue of absolute obedience. To the patient, she brought the selfless devotion of a mother. To the lower level hospital employees, she brought the firm but kindly discipline of a household manager accustomed to dealing with servants.
But, despite the glamorous "lady with the lamp" image, most of nursing work was just low-paid, heavy-duty housework [...] If anything, they toughened their insistence on lady-like character development, and the socialization of nurses became what it has been for most of the 20th century: the imposition of upper class cultural values on working class women. (For example, until recently, most nursing students were taught such upper class graces as tea pouring, art appreciation, etc. Practical nurses are still taught to wear girdles, use make-up, and in general mimic the behavior of a "better" class of women.) [3]

What I feel is so powerful about integrating queer liberation into labor struggles within healthcare, as well as challenge this ridiculous notion of LADY WITH A LAMP and its class affiliations, is also that it opens a way for us to change the PRACTICE of medicine and healthcare. I can't believe a queer-led labor movement within healthcare having no impact on the way the DSM designates transfolk, or the way the gender binary is enforced in medical practice through, for example, the mutilation of intersex bodies, or the rejectio of healthcare for transfolk; or the devaluing of bodies that have disabilities, that aren't "normal" under disableist society and its mimicking healthcare system.

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