by Susan Rosenthal
“Doctor, is the world getting sicker, or is it just me?” As I pondered this patient’s question, I thought about some of my other patients:
An anxious factory worker on a steady day shift, who was ordered to begin swing shifts the following week. The difficulty of arranging care for her two young children triggered a panic attack. Her supervisor sent her for treatment for anxiety.
A nurse with high blood pressure, who informs me that the hospital where she works has stopped providing combs for patients. Families are expected to provide these items and do the necessary grooming, but no provision has been made for patients without families. After weeks of neglect, an elderly woman needed her head shaved, and my patient was assigned to do the job. Her blood is boiling as she asks me, “How could this be allowed to happen?”
An exhausted bus driver, who worries that his employer will try to get rid of him now that he has a mental disorder. His doctor diagnosed him with Shift Work Sleep Disorder, which is listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.
Distraught parents with a depressed daughter who can no longer work. They can’t afford to support her, and they fear she will become homeless. They want me to place her in an assisted living facility. Their faces hit the floor when I inform them that such facilities are available only for those who can pay.
Yes, the world is getting sicker and so is everyone in it. Instead of addressing this social crisis, the medical system manages human misery by blaming the victim.
My patients are not responsible for their problems, and they are not alone. They would know this if they spoke with one another. But such communication is discouraged, so they confide in me instead. I am charged with keeping their “secret” (doctor/patient confidentiality) and treating their problems as individual, not social.
By focusing on individuals, medicine dodges the need for social change and defuses the class rage that could propel that change.
Human distress – mental, emotional and physical – is a natural response to unhealthy conditions. As the rich get richer, conditions deteriorate for the rest of us. To improve our health, we must organize to gain more control over our lives and our world. Solidarity is the best medicine.
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