And now a word from the health-care trenches:

[Brigid]

I am reading "God and Empire" by John Dominick Crossan. In it, he gets to talking about the sociological aspects of health, illness, and disease. He quotes a book entitled "The Illness Narratives" by Arthur Kleinman. In it, Kleinman quotes a young internist named Lenore Light, who is from an affluent black family but works in an inner-city ghetto clinic. Here is how she describes an encounter with one patient:

Today I saw an obese hypertensive mother of six. No husband. No family support. No job. Nothing. A world of brutalizing violence and drugs and poverty and teenage pregnancies -- and just plain mind-numbing crises, one after another after another. What can I do? What good is it to recommend a low-salt diet, to admonish her about control of her pressure: She is under such real outer pressure, what does the inner pressure matter? What is killing her is her world, not her body. In fact, her body is a product of her world. She is a hugely overweight hulk who is a survivor of circumstances and lack of resources and cruel messages to consume impossible for her to hear and not feel rage at the limits of her world. Hey, what she needs is not medicine but a social revolution.

I simply must find Arthur Kleinman's book.

[Warpy]

1. I came to the conclusion a long time ago

that most of the people I saw in the hospital were doing the best they could with what they had to work with. Some of us are just not given adequate means and it will always show. The worse wealth concentration gets, the more horribly it will show.

I always acknowledged my patients' ability to make choices. I was just there to tell them a few things that would keep them out of the hospital should they be capable of doing them. Some were, most were not. Sometimes there were very good reasons for the poor choices and I had to respect that.

The only way to cure all this is a clawback of all the money the billionaires have stolen since the late 70s, and I honestly don't see that happening any time soon.

The truth is that we're a sick country and getting sicker by the day and there is nothing much we can do about that.

[Cleita]

2. Yes, we have to cure society so we can then cure the individual. n/t

[MisterP]

3. Paul Farmer's "Infections and Inequalities" is also great social medicine nt

[HiPointDem]

4. big kr. i came to the same understanding of 'health care'.